Greater New York Hospital Association President Kenneth E. Raske is leading an unlikely crusade to resurrect the issue of America's uninsured.
Raske is trying to forge a national "Coalition for a Healthier America" to buy national television air time for a slick public awareness message that will serve as a "conscience-jogger." The GNYHA has dropped roughly $25,000 on the video. The audio portion will air on New York radio stations this week.
While healthcare institutions and companies in Indiana, New Jersey and Pennsylvania agreed to pony up $25,000 and $50,000 a pop to join the effort, the American Hospital Association has declined, Raske said.
Richard Wade, AHA senior vice president for communications, says Raske approached the national association last November, while the AHA was trying to put together its national agenda. "At that time, we were not in a position to invest in what he was doing," he says. "At some point, he asked us for a million dollars that frankly we didn't have."
In January, though, the AHA's board pledged to lead a national initiative to reduce the number of Americans without health insurance by 4 million within two years. When the board meets this month, it hopes to select three or four initiatives in which to participate (April 7, p. 122).
So what's in it for New York hospitals? "Nothing," declares Raske. "It's a moral thing." But won't hospitals reap the gains if more people are insured? "I guess you could have a jaundiced view*.*.*.*but the issue of the uninsured is only growing," he says.
Pulling no punches.A Boston-based watchdog group inducted Columbia/HCA Healthcare Corp. into its "Influence-Peddling Hall of Shame," accusing the company of using its political connections to sway state and national healthcare policy.
Columbia joined tobacco companies Philip Morris Cos. and RJR Nabisco, Dow Chemical Co., and waste industry giant WMX Technologies, which have been inducted in the past year.
INFACT, a 20-year-old group, staged a photo opportunity and press conference earlier this month at Columbia Sunrise Hospital in Las Vegas.
Columbia had little to say about the event. "It doesn't look like much of it is valid to me," says spokeswoman Eve Hutcherson.
INFACT denied it was citing Columbia simply because of recent negative headlines about the healthcare giant. INFACT cited a litany of statistics and pointed to Columbia's 97 registered lobbyists at the state level.
"Through the access that Columbia has to political officials, they are able to interfere with the decisionmaking process," says Kathryn Mulvey, executive director of INFACT. "They epitomize the giant corporations of today that are manipulating public policy."
Fighting over IPAs.Two associations are vying to represent the nation's growing number of independent practice associations.
The IPA Association of California recently became the National IPA Coalition, pitting itself against the 2-year-old IPA Association of America, known as TIPAAA. Both are based in Oakland, Calif.
The coalition aims to spread managed-care expertise. "Clearly there are some needs-very significant needs-that aren't being met," said Nancy Oswald, the group's executive director, who used to be vice president of government operations at New York City Health and Hospitals Corp.
TIPAAA President Al Holloway, who preceded Oswald as head of the IPA Association of California, said success breeds competition. He said his association has nearly 800 members in 30 states.
The coalition, which claims 140 members in eight states, officially will kick off a membership drive at its first national conference May 30-31 in Chicago.
Awakening. By reputation, radiologists are quiet, cautious people who sit in the dark gazing at X-rays and whisper patient reports into their Dictaphones. So it's worth paying attention when these mild-mannered doctors, through the Radiological Society of North America, issue a call for Food and Drug Administration reform.
Improved quality of patient care hinges on timely approval of new drugs and medical devices, the radiologists point out in a recent white paper. And FDA foot-dragging, the RSNA says, has seriously hindered U.S. patient access to many important developments, such as minimally invasive surgical treatments for strokes or precisely directed heat therapy for cancer. Red tape has also driven up costs for manufacturers, the radiologists say, raising prices for products such as nonionic contrast agents and in other cases discouraging company investments altogether.
So the RSNA recommends the FDA emulate European regulators by delegating some preliminary work to third parties, focusing on product safety and leaving the assessment of effectiveness and patient benefit to the medical community.
"Streamlining the current system," says Seymour H. Levitt, M.D., RSNA chairman, "will result in greater benefits for patients while simultaneously securing our nation's position as a leader in the development of breakthrough technologies that will improve patient care worldwide."
Quotables."(It's been reported) 82% of hospitals that own physician practices were losing money. I consider that to be a boldfaced lie. There's no way 18% of those hospitals are making money."-Robert W. Daly, managing director of TA Associates, a Boston-based private equity investment firm, speaking at the Physician Practice Management Companies Profitability Forum in Washington last week.
n"We have to publish the goddamned regulations implementing Stark II. And we will do that within all of our lifetimes."-HCFA Administrator Bruce Vladeck, speaking to a National Association for Home Care conference in Washington. The Stark II legislation, which bans physicians from referring patients to facilities in which they have a financial interest, became law in 1995, although HCFA has published no rules to clarify how it will enforce the law.