South Florida Hospital News
Tuesday July 7, 2020

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June 2009 - Volume 5 - Issue 12


Health Care Reform: Get Involved

Many predict this will be the year for the most dramatic health care legislation, since Medicare and Medicaid were adopted in 1965. We have already seen a major expansion of Medicaid coverage for children and their parents under the SCHIP program, and more expansive legislation is expected this Summer and Fall. Active participation in the legislative process by industry participants, particularly clinicians (nurses, nurse practitioners, physicians, etc….) and health care administrative professionals, is critical to the production of meaningful legislation, legislation that improves the access to health care services, while not diminishing the quality and quantity of medically necessary and appropriate health care services.

While Industry Associations play an active an important role in the legislative process, it is not sufficient to rely on your industry or professional association to deliver your input to policy makers. Despite cynical presumption to the contrary, your elected officials want to hear from you, and you can make a difference. Contact your elected official, by email, phone or, more importantly, in person. Don’t be offended if you only get to meet with a young legislative assistant; members of Congress are very busy and difficult to schedule, but their staff are very accessible. Deliver your message succinctly, with a one-page statement of your position. Facts are always helpful, and emotional pleas of "doom or crisis" rarely help your cause. It is very easy to identify your local representative and to contact them. (named after Thomas Jefferson) has simple tools for identifying your member of Congress by your zip code. You can also determine if your Representative or Senator are on a relevant committee.

It is important to know the key decision makers. If your Representative and/or Senator is on a relevant committee, you have a better opportunity to influence the outcome. The following Members of Congress and Committees must approve and control all health care legislation. Charles Rangel, (D-NY) Chairman of the House Ways and Means Committee, Pete Stark (D-Ca) Chairman of the Health Care subcommittee of the House Ways and Means Committee, and Henry Waxler (D-Ca) Chairman of the Energy and Commerce Committee.

The Senate Finance Committee controls all health care legislation in the Senate, with the HELP Committee also playing an active role. Senate Finance is Chaired by Max Baucus (D-Mt) and Charles Grassley (R-Iowa) is the ranking minority member, but very influential and close working colleague to Senator Baucus. Ted Kennedy (D-Ma) chairs the HELP committee. Of course, Senator Harry Reid (D-Nv), as Senate Majority Leader, controls how bills are handled for votes.

This year, the key message points for debate include: (a) government option (a government operated insurance program anyone can pay to participate), (b) universal access, (c) insurance reform, (d) sustainable growth rate, (e) comparative research, (f) Union card check, (g) medical home, (h) government mandated coverage, (i) global case rates, (j) imaging and hospital self-referral (physicians referring patients to facilities they own), and (k) pay for performance. There are others, but it is important to know the context of each of these issues, how legislation will address these questions in an effort to increase access, lower cost and increase quality. The issues are complex, the solutions are not easy, and the potential tax and societal impact could be enormous.

The challenge for this, and future presidents congresses, and state houses, is how to balance and improve access to all, without taking away (i.e., rationing) the access and the quality of care enjoyed by more than 80% of all Americans. Many bi-partisan health care policy experts acknowledge simplifying and reducing the administrative cost and complexity burdens alone, could save more than 10% of the national health care expenditure, savings that far exceed the cost to provide a high quality package of services (i.e., insurance coverage) for all uninsured. Also note, we have over $1 trillion of health care facilities (facilities built with government Hill-Burton Act funds in the 50s and 60s) that need to be replaced; replaced with outpatient centers efficient for physicians and located conveniently for mothers and families. Consider these simple objectives and solutions: An efficient payment system, newer, efficient facilities, and incentives for higher quality of care, can all be very beneficial to improving the access and quality of care, lowering the cost of care, and do it all, without taking away from anyone access to the best health care services the World has or will ever know.

Get involved!

John T. Thomas, EVP-Medical Facilities, Health Care REIT, Inc., can be reached at
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