The Clintons rode into town on white horses in 1993 determined to reform, manage and manipulate the nation's splintered healthcare system. Their plan failed miserably.
In 2001, a new president has an opportunity to reinvent and re-energize healthcare. In this space last week, Managing Editor Neil McLaughlin urged the healthcare industry to make no small plans as its grapples with the burden of medical errors, patient privacy and information security. He's right, but big ideas and determination alone won't do it. Profit-pinched healthcare providers need a financial boost.
President Bush and Congress should support the effort to improve productivity and efficiency by creating a mechanism to assist hospitals in building a quality-based infrastructure. Just as the Hill-Burton program funded hospital construction after World War II, the new initiative would help healthcare providers invest in the tools necessary to cope in the modern world of medicine.
The politicians must remember that many of the changes facing healthcare providers are essentially unfunded mandates. Complying with the Health Insurance Portability and Accountability Act of 1996, for example, could cost hospitals billions of dollars. Although HIPAA's intent to simplify and standardize healthcare transactions is sound thinking, the cost of implementation remains beyond the means of many hospitals that depend on government-regulated reimbursement rates for the bulk of their revenue.
The recent Institute of Medicine report sets the bar even higher. In attempting to design a blueprint for a 21st century healthcare system, the IOM recommended the elimination of handwritten clinical information by 2010 and other costly reforms. The report also called on Congress to create a $1 billion "innovation fund" to jump-start the process.
Nobody can argue with the IOM's goals of making healthcare safe, effective, patient-centered, timely, efficient and equitable. Getting there is the hard part.
To stifle partisan political bickering, President Bush and Congress could unite in their support of re-engineering the healthcare system. Both sides have generally agreed to support medical research and children's health initiatives. It's time they realized the wisdom of investing in the building blocks of quality care.