Reforming state health coverage policies and investigating coverage options at the national level will be important issues during the 2008 U.S. presidential election, says Kenneth E. Thorpe, PhD, Emory University public health and policy researcher.
Dr. Thorpe, professor of health policy and management at Emory's Rollins School of Public Health, will weigh in on presidential candidates' health care reform plans at the National Press Club in Washington, DC on April 25 (more information on the WHSC web site) as well as the feasibility of state reforms proposed by lawmakers in California, Massachusetts and Vermont.
Dr. Thorpe cautions that cost controls are the key to success of any national or state health reform program. He says the long-term affordability and sustainability of a health care system is dependent upon removing administrative costs from the system, changing the delivery of health care services for the chronically ill, and increasing investments in public health programs targeting health conditions like obesity that account for the majority of cost inflation.
Caring for the chronically ill and obese is draining America's health care coffers, Dr. Thorpe says. About three-quarters of current health care spending in this country is linked to patients with chronic diseases such as high blood pressure and diabetes.
"The data indicates a clear need for restructuring," Dr. Thorpe recently told a group of Massachusetts health officials convening to discuss universal health care. "It's more complicated than dialing up or down co-pays for health care."
Confronting these issues should be the No. 1 priority for a health care system that still pays its providers using an archaic delivery system that's failed to keep pace with the country's changing demographics and health care needs, he adds.
Dr. Thorpe recommends overhaul of the fee-for-service payment system currently used by Medicare, noting that such a system doesn't adequately permit an integrated delivery model that includes preventive care, outpatient services and follow-up reminders that keep people healthy and significantly reduces physician office and ER visits.
"Right now we have a fragmented, independent, unconnected system," Dr. Thorpe says. "But a fragmented fee-for-service approach to pay for continuum of care doesn't really make sense."
He says Medicare should be modernized, and incentives given to physicians who reduce a patient's long-term problems. Dr. Thorpe also advocates cost-cutting measures for employers who provide health insurance to employees.
Dr. Thorpe is formerly Deputy Assistant Secretary for Health Policy in the U.S. Department of Health and Human Services under President Clinton. He has testified before several committees in the U.S. House and Senate on issues of health care financing, insurance and health care reform and is a frequent commentator for print and broadcast media. (Full bio on the WHSC web site.)
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