Idaho is not waiting for federal healthcare "reform"

Governor C.L. “Butch” Otter wrote a nice opinion piece (source at the bottom):

It seems like Washington, D.C., is tilting at political windmills these days. The Obama administration and Congress are still promising to slay the fire-breathing dragon of healthcare costs. But the beast they are fighting is, to a large extent, the product of the government-installed cage in which it evolved.

For 35 years now the federal government has been essentially running healthcare in America, masking market signals and supplanting the judgment of patients and physicians with the determinations of politicians, bureaucrats and lawyers. It should be no surprise that healthcare became “health management,” people became statistics, and the fear of liability became the biggest expense of all.

Now the federal government is poised to rescue us from the disaster it created, promising “reform” that amounts to little more than increasing government’s already dominant role in the healthcare system and further reducing the role of states like Idaho, not to mention individual patients and providers.

The public, policy makers and even patients contributed to the problem with their complacence. Having been lulled into a false sense of security by the promise of Medicaid and Medicare, we failed to insist on meaningful change and self-determination. But now the federal government has seized on healthcare reform as its mission in life, which means we should brace for still higher costs.

Largely missing from this discussion is the real work that Idaho and many other states are doing on their own to address healthcare needs, fulfilling their role as laboratories of the republic. That work includes controlling costs and improving access through a market-driven focus on preventive care, health promotion, building public-private partnerships, and application of technology and professional development.

I convened the Idaho Healthcare Summit in 2007 to evaluate Idaho’s healthcare system and recommend ways to make healthcare more affordable. The Governor’s Select Committee on Health Care evaluated the recommendations, gathered additional data and provided its top recommendations for implementation in a report submitted to me in 2008.

The recommendations focused on expanding the statewide use of electronic medical records to provide better coordinated patient care; expanding the use of patient-centered medical homes that shift the focus of healthcare to primary and preventive care; expanding the number of already eligible children to register for the State Children’s Health Insurance Program; and expanding the number of residency opportunities to attract primary care and specialty physicians to our state. We are making great progress on all those fronts. And at the close of 2009 I created the Governor’s Health Policy Implementation Committee, consisting of people who are experts in these fields, to foster continuing advancement of the priority areas over the next couple of years.

While there is still much more to be done, this much is clear: The federal government should not dictate our healthcare choices. The states, with public and private input, are capable of making changes to foster a better and more affordable healthcare system. We no longer can afford to be complacent and wait for the federal government to make things worse and take decisions out of our hands.

As Thomas Jefferson said, “A wise and frugal government, which shall leave men free to regulate their own pursuits of industry and improvement, and shall not take from the mouth of labor the bread it has earned – this is the sum of good government.”



Source: http://gov.idaho.gov/mediacenter/press/pr2010/prmar10/pr_017.html

Obama to Observe Green Bay's Healthcare Model

According to a recent Washington Post article, Green Bay, Wis. is one of the best cities in the country according to numerous measures. The city has "managed to control medical spending while steadily improving health outcomes."

Peter Orszag, the Obama administration's budget chief, said, "If we could make the rest of the nation practice medicine the way that Green Bay does, we would have higher quality and significantly lower costs."

In his drive to rein in skyrocketing health-care costs, Obama is increasingly focused on wasteful medical care that does not extend life and may actually be harmful. Today's town-hall-style meeting, his first as president to promote health reform, is intended to spotlight one city's strategy for squeezing out waste without hurting quality.

What Obama is likely to hear in Green Bay is testimony to the value of digital records, physician collaboration, preventive care and transparency, say those most involved in Wisconsin's innovative approach.

"There's been a fairly steady progression of quality" in areas such as diabetes care and cancer screening, said Chris Queram, executive director of the Wisconsin Collaborative for Healthcare Quality, which publishes statewide performance measures....The federal Agency for Healthcare Research and Quality gives Wisconsin high scores on 100 measures, ranging from the treatment of heart disease to childhood asthma.

However, what's exciting the Obama administration the most? The Dartmouth Institute for Health Policy and Clinical Practice have some very interesting findings.

The New Hampshire researchers have documented and mapped wide variations in the cost and types of care given to American seniors through the Medicare program, concluding that spending more on health care has not resulted in better health.

For example, the researchers found that In the final two years of a patient's life, Medicare spent an average of $46,412 per beneficiary nationwide, with the typical patient spending 19.6 days in the hospital, including 5.1 in the intensive-care unit. Green Bay patients cost $33,334 with 14.1 days in the hospital and just 2.1 days in the ICU, while in Miami and Los Angeles, the average cost of care exceeded $71,000, and total hospitalization was about 28 days with 12 in the ICU.

Are these differences attributed by big-city prices? According to the article, maybe. WP interviewed a Elliott Fisher, principal investigator for the Dartmouth Atlas Project, who said "but the differences that are really important are due to the differences in utilization rates." That is key, the "utilization rate". This is why the Obama administration is so interested in the study. If we are utilizing our resources at an optimal level, we are operating at an optimal level.

Click here to read the full article

President Obama & EMR

According to a White House bulletin, President Obama laid out an outline of five "key areas" that his administration will pay particular attention to, one of which is EMR.

"...we will continue to invest in the cutting-edge research and development necessary for the innovation and discovery we need to meet the digital challenges of our time. And that's why my administration is making major investments in our information infrastructure: laying broadband lines to every corner of America; building a smart electric grid to deliver energy more efficiently; pursuing a next generation of air traffic control systems; and moving to electronic health records, with privacy protections, to reduce costs and save lives."