House Speaker Newt Gingrich (R-Ga.) gave a glimpse last week of the GOP's strategy to combat attacks that Republicans have sought to slash projected Medicare spending by $270 billion over seven years in order to finance a tax cut for the wealthy.
Much is riding on Gingrich's effort. The party's presumptive nominee, Bob Dole, is floundering in the polls, and the AFL-CIO is in the midst of a $35 million advertising campaign targeting 70 House Republicans for their votes on the GOP budget plan.
Gingrich said Republicans will seek to frame the subject of Medicare as a tax issue and the Democrats' response "as a scandal."
He said the tax cut should be an easy sell with a tax-weary public. And it contrasts sharply with a comment made earlier this year by Rep. Fortney "Pete" Stark (D-Calif.), who said that it might be desirable to have a limited increase in taxes to stabilize the Medicare Part A trust fund. Republicans will argue that without slowing the rate of growth in Medicare, taxes will be so high that they will stifle economic growth.
Gingrich also said Republicans will attack as a "scandal" President Clinton's repeated assertion that the GOP budget would "cut" Medicare when in fact it would only slow the rate of growth. The speaker added that the media was an accomplice in the scandal for repeating the Clinton charges. Adding to the scandal, according to Gingrich, are Democrats' attempts to scare seniors into believing that Republicans were trying to eliminate Medicare.
In medicine, paperwork is public enemy No. 1. No wonder some physician organizations are trying to eradicate redundant documents.
California physician associations recently unveiled a standardized credentialing form. Physicians in Washington state are developing their own version, to be implemented this fall.
Until now, each HMO and hospital has had its own form-some as long as 15 pages-on which doctors fill in their education, licensure, training, disciplinary and malpractice data.
That adds up to reams of paperwork. In Washington, medical groups typically contract with 10 health plans and have staff privileges at one or two hospitals, said Marcy Shimada, a consultant who is coordinating the effort in the state. For a medical group with 100 physicians, that's 1,200 documents that must be completed and updated.
Physicians were so frustrated, the Washington State Medical Association last year selected a company to collect physician data and charge health plans and hospitals to access it. That displeased the plans and hospitals, prompting a dialogue on how to streamline credentialing, Shimada said.
In Washington, HMOs accept the idea of a standard form, but some hospitals are unwilling to relinquish their own pet procedures, Shimada said. In California, at least one major health plan, CaliforniaCare, has agreed to accept such a form.
There appear to be too many consultants going out on their own and not enough names to go around to title their new ventures.
Just this month, David A. Anderson, 49, a longtime partner with KPMG Peat Marwick, retired to form his own healthcare consulting firm after 25 years with Peat Marwick.
Anderson is founding Health Care Futures, which will be based in Itasca, Ill. Anderson's firm isn't to be confused with Bannockburn, Ill.-based Health Futures. Jeff Goldsmith, a healthcare "futurist," is president of Health Futures and a national adviser for Ernst & Young. "It's purely coincidental," Anderson said of his firm's name. "I don't think you can name anything in healthcare these days without coming close to something. I was thinking of `Modern Health,' but that would be too much like (MODERN HEALTHCARE)."
Allegiance Corp., the soon-to-be spinoff of Baxter International, has some healthcare powers lined up for its board of directors. Among them: Kenneth Bloem, 50, chief executive officer of the Advisory Board Co., and Silas Cathcart, 70, former Kidder, Peabody Group chairman and CEO. Another name you might recognize is former American Hospital Association nursing vice president Connie Curran, 49, now president of CurranCare, a home-care company.
While driving west on Venice Boulevard in Los Angeles, Outliers did a double-take. The billboard showed a woman's eyes, with a penetrating gaze. "Your body is a personal road map. You should be the guide," the ad read.
In fashion-conscious, individualistic L.A., this had to be an ad for yet another expensive personal-care product.
Nope. It's an ad for Blue Shield of California's Access+ HMO, which allows members to access specialists directly without a referral from their primary-care physician. Having to check with a "gatekeeper" to get specialist care is one of the main gripes people have about HMOs, research shows.
Later, driving east on Venice, we were intrigued by another Access+ billboard. This time, it said "You've lived in your body your whole life. That makes you the landlord."
Blue Shield's campaign theme, "Nobody knows you like you," is running through December in key California markets-Fresno, Los Angeles, Sacramento, San Diego and San Francisco. The ads, created by McCann-Erickson in San Francisco, appear on TV, radio, billboards, bus shelters and in newspapers. Blue Shield declined to say how much the campaign will cost.