You couldn't blame those attending the recent American Hospital Association annual membership meeting in Washington for feeling a bit conflicted. Public officials speaking at the event pelted the audience with enough contradictory messages to leave everyone with a severe case of cognitive dissonance.
Take, for instance, the presentation by Senate Majority Leader Bill Frist (R-Tenn.). Frist, a heart transplant surgeon and member of the HCA clan, noted-more than once-that he had spent 80,000 hours in hospitals. (Of course, there were many people in the hall who could have beaten that record and boasted of actually running a hospital.) Adding astrologer to his already hefty resume, Frist asserted that the "legislative stars are aligned in an unprecedented way" for passage of bipartisan Medicare reform that includes a prescription drug benefit. He then drifted from bipartisanship by complaining about opposition to one of President Bush's conservative court nominees and touting Bush's "bold initiative" on Medicare at least three times. And he superimposed charts on healthcare advances and system changes that seemed to prove something to him about the need for reform, but to others they suggested the need for a refresher course in graphics.
Despite his healthcare credentials and connections, the senator garnered a polite but generally reserved reception from the audience. One AHA official, speculating on the lukewarm reaction, pointed to the managed-care components of the Bush plan. The hospital crowd, he noted, has a lot of bad experience with HMOs.
Rep. Greg Walden (R-Ore.) stumbled into one of the biggest contradictions at a gathering of hospital trustees. After trumpeting his concern for healthcare and his opposition to earlier Medicare cuts, Walden went into a rhetorical tap dance when a listener asked how the nation could afford adequate healthcare funding and big tax cuts. He answered the economy is in the trash bin and needs stimulating and, besides, he only supports a $550 billion cut instead of the administration's $726 billion.
Sen. Edward Kennedy (D-Mass.) inadvertently highlighted a related conflict. His often-rousing denunciation of Bush's Medicare and Medicaid proposals and his cries for increased funding of a litany of healthcare programs drew frequent and thunderous applause.
But the senator's assertion that "healthcare is more important than large, large tax cuts for millionaires" drew only scattered applause. And that gets to the heart of the conflict: We Americans want government to provide everything we think we're entitled to, but we don't want to pay taxes. Even as the AHA attendees petitioned lawmakers for more reimbursement, many appeared reluctant to let go of the tax goodies. There is no mystery in this. One survey showed that median total cash compensation for hospital administrators, presidents and chief executive officers for 2002 was $273,367. By comparison, the U.S. Census Bureau reports that median household income for 2001 was $42,228.
If those in the healthcare trenches turn squeamish at the sight of taxes, how can public officials be expected to risk their political necks?
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Please join us in congratulating our New York bureau chief, Cinda Becker, for winning the National Institute for Health Care Management's 9th Annual Health Care Journalism Award for Excellence in Health Care Reporting. Becker was recognized for her Oct. 21, 2002, cover story on the financial and policy consequences of the new drug-eluting cardiac stent, which was recently approved by the Food and Drug Administration (April 28, p. 4). The institute will honor Becker and Modern Healthcare at a May 22 dinner in Washington. Becker's story, which translated the medically technical into practice business advice for our readers, is yet another example of why Modern Healthcare is the best-read healthcare business publication. Her story also served as the prototype for our monthly Medical Advances section, which debuted this year (See p. 30).