Still, yesterday’s announcement was big news, and the actors got the applause they sought. The Spanish language station Univision called the announcement “historic,” the same term the President used. USA Today’s story was upbeat, giving AHIP president Karen Ignani the last word and letting her spread the message her group has been peddling for months: “Cost savings of this magnitude could go a long way toward ensuring that every American has access to affordable, quality coverage.” While the President and the industry were playing to the crowd, a senior administration official was more honest, telling Ezra Klein at The American Prospect’s blog: “This is a commitment, not a plan.”
Although most journalists understood that the gesture had no teeth, they didn’t address the touchier subject of real cost containment, like capping spending in various health care sectors. These groups—the docs, the hospitals, the drug companies—would wage a holy war against such controls, which is why the pols aren’t pushing them.
So instead we urge the media to strike out on their own and use the industry letter as a departure point for exploring some real cost containment questions, and the disconnect between reality and a PR stunt.
• Will the SEIU really tell nursing homes and hospitals to pay its members less? That’s hardly a recipe for organizing workers.
• How does this gesture square with the AMA’s current drive to make sure doctors don’t get the large cuts in their fees scheduled for next year? The fee cuts were part of past government attempts to slow the spending on doctor care in the Medicare program, but docs don’t want to lose the income.
• Will big PhRMA continue to increase costs of brand name drugs to compensate for lost revenue from greater use of generics?
• How do increased costs generated by the hospital industry’s building spree, the biggest in decades, mesh with yesterday’s letter?
• Will the medical tech industry stop pressuring Congress to intervene each time Medicare says it won’t pay for this treatment or that because the evidence is not there or is unclear?
Campaign Desk would like to see some answers.
The Big 4stakeholders+token union representation mouth ALL of the Republican talking points and market them slickly packaged as DTC advertising. Obama's buying, and curiously, Sibelius wasn't in the photo op. All of the real reform players and initiatives are off the table: primary/preventive/public healthcare, funding and growing primary care physicians and baccalaureate educated nurses (who are educated and clinically qualified to provide disease managements, comprehensive patient case management and community/public/home health nursing), and openly discussing rationing at the tertiary level instead of the continued invisible rationing that keeps people out of all of the lines trying to get access and affordability. 7 of every 10 women in the US now find themselves shorted in getting essential healthcare..
No one is speaking single payer and no one is talking directly to patient advocacy and patient safety organizations. Nurses, of course, have been excluded from representing themselves and their interests (which, by the way, include by ethics and statute the requirement to serve as patient safety advocates across all healthcare settings and services). What a total sham.
Except this time the public is furious, curious and are suffering and dying as a direct result, so they do have literal skin - and hearts and brains - in the game.
The question is whether they will take action in time to derail the for-profit marketing train before it leaves the station?
Reed Abelson reported that nurse directed disease management programs were so successful in terms of patient quality, that they were shut down because their hospital employers lost revenue from the avoided inpatient stays. I used to direct patient throughput, and I can tell you that the game is stacked - green lighted for patients with high reimbursement rate diagnoses/treatments and red lighted until death for those with multiple complex chronic diseases which are reimbursed poorly and eat up scarce resources while incurring considerable risk to hospitals (morbid obesity causing staff injuries, higher morbidity and mortality rates, higher Mediciad rates or self pay, etc.)
As soon as health care went from not-for-profit to a for profit business model, it was doomed to fail. healthcare is a public good, a public service and a moral imperative. It's just like fire safety and emergency services: when you don't have it, the entire community is at risk and is poorer.
But until those Republican talking points are buried and never exhumed by the media, the public will never be accurately and fully informed.
#1 Posted by Annie, CJR on Tue 12 May 2009 at 05:42 PM
You are VERY RIGHT!! Most of those VOLUNTARY promises made by the AMA etc are whistling in the wind. They are trying to be "little goodie two-shoes" and maybe the President and/or Congress will believe them. I hope Pres. Obama is still not the "sap" that the Republicans tried to play him for. He claimed in February he wasn't. But with Congress it's hard to tell. Barney Frank will tell most of them off as needed but which others will is hard to tell. Some will call their "allowances" to be political actions to gain votes. REALLY!!?? We need some decent health care programs but we can't be too regimental with who can use which medical machine or medication. I know from personal experience that not all generic medications work exactly like their predecessor. I take 2 medications and one is generic but the other is not. The latter as generic doesn't work for me as does the primary one. Brand names must not determine good or bad but use and action with the patient. Keep hounding the media and the government to do things right. Obama can't set the law; only Congress can--if they have the backbone!!!!
#2 Posted by Patricia Wilson, CJR on Wed 13 May 2009 at 03:00 PM