Opinion Pieces Address Various Aspects of U.S. Health Care System

• Rep. Robert Andrews (D-N.J.): A provision in the Children's Health and Medicare Protection Act considered by lawmakers last year would have established "a demonstration program for up to 10 states to offer employers and their employees the option to buy into" SCHIP, Andrews, chair of the House Education and Labor Subcommittee on Health, Employment, Labor and Pensions, writes in an opinion piece in The Hill. He continues, "Unfortunately, the proposal was not included in the final conference report of the CHAMP Act due to claims that provision would lead to government-controlled socialized health care" -- claims that are "simply not true," as "at least 48 states currently run their SCHIP programs through a private insurance provider." Andrews says that he plans to introduce legislation in the coming months that will offer "a real solution to reduce the number of the uninsured" (Andrews, The Hill, 4/16).
  
  
• Rep. Lois Capps (D-Calif.): "In all countries, a functioning health care system that connects underserved communities to obstetric and emergency care must be established and sustained," Capps, a former public health nurse, writes in The Hill. Capps notes that the U.S. "ranks 41st in maternal mortality in the world and dead last among industrialized nations, despite our unprecedented wealth and advanced medical technology." Capps says Congress should approve legislation that would increase the "U.S. contribution to reducing maternal and infant mortality internationally and at home," as well as "provide necessary resources to [CDC] to improve data collection and analysis" (Capps, The Hill, 4/16).
  
  
• Carolyn Clancy: Consumers do not have the option of getting basic information about health care quality and cost before making health care purchasing decisions, "despite the potentially life-threatening ramifications of choosing poor-quality health care," Clancy, director of the Agency for Healthcare Research and Quality at HHS, writes in The Hill. She continues, "We need to make our health care system one that rewards quality and value, rather than volume." This can be achieved through several measures, including increased transparency, Clancy writes, adding that HHS is working to increase transparency through a Web site that "provides information on 26 quality measures, including process of care, which reports how well a hospital provides care, and outcome measures, which reflect the results of the care patients receive." The Web site also "adds detailed information about patient experiences with their hospital care," she writes (Clancy, The Hill, 4/16).
  
  
• Rep. Diana DeGette (D-Colo.): The Bush administration has "ignored" the "deteriorating situation" of the uninsured population in the U.S. and "has even made it worse," DeGette, vice chair of the House Energy and Commerce Committee, writes in The Hill. DeGette says that the "Bush administration continues to make it difficult for states to provide health care" by vetoing an SCHIP expansion, imposing "draconian Medicaid regulations" and proposing "an anemic budget for scientific research." She writes that the "new leadership of Congress recognizes the crisis in health care and is working to expand the system for every American," with the goal of turning "the administration's missteps into opportunities to improve our health care system" (DeGette, The Hill, 4/16).
  
  
• Rep. Sandy Levin (D-Mich.): "With our sprawling health care system, the government must create procedures to encourage individuals, their families and their doctors to discuss the type of medical care they would like to receive well in advance of a crisis situation," Levin, a member of the House Ways and Means Committee, writes in an opinion piece in The Hill. Levin says that she and Rep. Mike Castle (R-Del.) have introduced legislation that "is designed to make more Americans aware of advance directives (which include a living will stating an individual's preference for medical care and a power of attorney for this care) and provide the opportunity for them to discuss advance directives with a physician and ensure the directives are honored throughout the country" (Levin, The Hill, 4/16).
  
  
• Rep. Doris Matsui (D-Calif.): "Nearly one-quarter of public health workers will be eligible for retirement over the next five years," and, "as these professionals exit the ranks of the work force, too few graduates are available to replace them," Matsui writes in an opinion piece in The Hill. The U.S. "cannot afford these shortages" because the "public health work force is the bedrock of our emergency preparedness," Matsui says. Matsui writes that she has proposed legislation that aims to "rebuild the public health work force through multiple avenues," including "scholarships for public health students who agree to enter into public health professions after graduation," improved retention of "graduates that we already have in the public health field" and "a loan repayment program" that "will help current public health workers repay student loans" (Matsui, The Hill, 4/16).
  
  
• Sen. Lisa Murkowski (R-Alaska): "If we continue to ignore the importance of prevention-focused health care, we will be faced with sicker patients, a more costly health care system and insurance premiums that price individuals, families and employers out of the health insurance market," which is "something this nation cannot afford," Murkowski, a member of the Senate Health, Education, Labor and Pensions Committee, writes in an opinion piece in The Hill. According to Murkowski, if the U.S. wants "to truly make health insurance affordable and reduce the number of people falling victim to chronic disease, we must combat" the costs of chronic illness "through better prevention and by rewarding physicians who provide quality care and achieve positive outcomes." She adds that preventive care incentives are "working in the private sector" and we "can make it work for federally funded programs, as well" (Murkowski, The Hill, 4/16).
  
  
• Rep. Tom Price (R-Ga.): "There may be no greater negative impact on the 'manner in which medical services are provided' than the federal government's intrusion into health care, primarily through Medicare," Price, a former orthopedic surgeon, writes in The Hill. According to Price, "Our broken medical delivery structure is in dire need of meaningful reform," but "Medicare must not be the model" because its "fundamentally broken structure fails many seniors and requires its own patient-centered improvements, not broad expansion." He adds, "Our focus for positive transformation must be cost of care, access to care and quality of care," all of which "Medicare comes up short on." Price offers the solution of "restoring our focus to those most intimately affected by health care decisions -- patients," which will allow for a "transition to a financing and delivery system which will accomplish insurance coverage for all without sacrificing quality and access" (Price, The Hill, 4/16).
  
  
• Peter Pronovost: While the U.S. "is more productive in biomedical research than the entire European Union" and "the entire world looks toward the United States for major breakthroughs in medical research," its medical system ranks "dead last among other industrialized nations in terms of quality, access, efficiency, equity and outcomes," Pronovost, medical director of the Center for Innovation in Quality Patient Care at Johns Hopkins University, writes in The Hill. He continues that "this dichotomy is the result of our national failure to view the delivery of health care as a science," as the "majority of federal research funding supports what is often considered 'biomedical science' -- principally efforts to understand disease biology and identify promising new therapies for a variety of diseases." Meanwhile, "[e]fforts to understand how to deliver those complex therapies safely and effectively are underfunded," Pronovost adds. "Given this imbalance, it is understandable, perhaps predictable, that the U.S. has some of the best basic and clinical science research, yet the worst patient health outcomes in the industrialized world," he writes (Pronovost, The Hill, 4/16).
  
  
• Michael Tanner: If Sens. John McCain (R-Ariz.) and Barack Obama (D-Ill.) become the presidential nominees this fall, the U.S. "may see a subtle but useful shift that could actually lead to improving how health care is provided in this country," Tanner, an author and senior fellow at the Cato Institute, writes in an opinion piece in The Hill. Tanner says, "Overall, McCain has the better proposal" because "Obama's plan, with its heavy reliance on government, leads to the same problems that bedevil universal health care systems all over the world: limited patient choices and rationed care," while "McCain's proposal is much more consumer-centered and taps into the best aspects of the free market" (Tanner, The Hill, 4/16).