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What’s Going On Behind Closed Doors In Washington On Healthcare Reform?

bill-novelliToday there was a Fiscal Responsibility Summit held at the White House. Bill Novelli, CEO of the AARP attended the summit as part of the work group on health. Bill reported what he observed in his work group (which consisted of notables such as Senators Baucus, Rangel, and Specter, Nancy Pelosi, Nancy Nielsen, MD, Becky Patton, RN, Rich Umbdenstock and others) on a special media conference call today.

The over-arching theme of the work group discussion, according to Bill, was prevention and wellness. The group agreed that the key to improving Americans’ quality of life and controlling the costs of chronic disease lies in preventive health efforts. In addition to this belief, the group agreed that:

1. Healthcare reform must be achieved as quickly as possible. The path to long term entitlement sustainability requires healthcare reform. Simply expanding access to a broken system is not the solution.

2. The American people need to be engaged in reform efforts – not just as patients, but as tax payers and voters. They need to understand what they will gain and lose.

3. We must reward adherence to best practices and healthcare quality.

4. A public-private partnership is critical to achieving reform.

A few interesting points were raised by various stakeholders in the meeting:

1. Arlen Specter – believes that changes in medical approaches to end-of-life care could decrease costs substantially. He called for more advanced directives, and education about end-of-life care options.

2. Dr. Nancy Nielsen – called for Medicare to fix the physician fee schedule.

3. Becky Patton – called for increasing the nurse and healthcare workforce.

4. Rich Umbdenstock – requested that more attention be focused on pay for performance and administrative simplification initiatives.

I asked Bill how many providers were included in his work group, and he mentioned three (Nielsen, Patton, and Umbdenstock – not really a provider himself). Best I could tell, there was only one physician and one nurse at the meeting. And that is fairly shocking to me.

If healthcare reform is happening without much input from the primary providers of care (doctors and nurses) – will the reform decisions made by these well-intentioned individuals make good clinical sense?

Another reporter asked Bill what he thinks will happen with healthcare reform in the near term. His answer was telling: “We don’t know.”


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