The Catholic Health Association unveiled its draft healthcare reform principles last week, joining a crowded field of players vying to influence public policy as the 2008 presidential race heats up.
The faith-based trade group endorsed universal coverage in its 16-point list of reform essentials, but did not set any criteria for how to get there. Indeed, of the principles listed, only two suggest specific policy points. Its architects said the list, once completed, is intended to be a standard for measuring policy proposals, not a road map for reform. The St. Louis-based trade groups strategyprinciples first, policy latermirrors that of the American Hospital Association, which began floating its reform draft in March and is expected to release a more comprehensive, final agenda in July (March 26, p. 8).
Similar to the AHA, the Catholic trade group said that with universal coverage comes a collective responsibility for shouldering the cost. The associations also both call for more preventive care and greater efficiency.
But the duos initial agendas hold a few differences. The AHA outline endorsed incentives for providers and patients, including rewards for healthy behavior.
The CHA, meanwhile, urged changes to curb spending on care that medical judgment determines to be futile and respect for patients diverse spiritual beliefs, particularly at the end of life.
There are lots of different ways to get healthcare for everyone, said Sister Carol Keehan, CHA president and chief executive officer. We are not wedded to one structure.
Expanding access should entail a basic benefit package available to all that runs the gamut from preventive to end-of-life care, the CHA principles say. Other proposals include: guaranteed care regardless of age, health, income or employment; standards for information technology; and financing for care that fairly and equitably distributes costs. Two principles push for more definitive changes. The first supports progressive taxes to back public-sector health programs; the other calls for a ban on public financing for care considered unethical by the nations Catholic bishops, such as abortion.
Other trade groups have not been as shy about putting forward detailed plans. The Federation of American Hospitals, which represents investor-owned facilities, issued a detailed proposal to achieve near-universal coverage through a combination of tax breaks, expanded public safety net plans and subsidies for private insurance for those unable to afford care and ineligible for existing public coverage such as Medicaid (Feb. 26, p. 6).
In November Americas Health Insurance Plans released its blueprint, which the trade group contends would cover all children in three years and nearly all adults within a decade at a cost to the federal government of $300 billion. And the AHA and CHA, along with the federation, AHIP and a dozen other healthcare companies and organizations, backed an expansion initiative that seeks to cover children by expanding the State Childrens Health Insurance Program.
Daniel Hale, executive vice president of community benefit and public affairs at Trinity Health, a Catholic system based in Novi, Mich., said escalating healthcare costs and the building political momentum behind reforms prompted the Catholic association to release its principles. The time is right, said Hale, who helped draft the principles and unveiled it at the CHAs annual meeting in Chicago on June 18.
Catholic health executives backed the principles and the associations less-direct approach to shaping policy in the coming presidential election.
This is a good foundation to work from, said Richard Statuto, president and CEO of 15-hospital Bon Secours Health System, Mariottsville, Md. Statuto argued that principles stand a greater chance of success as diverse, sometimes conflicting players seek to shape, reform and build widespread public support for change. Policies become targets for competing interests, he said.
Lloyd Dean, president and CEO of 43-hospital Catholic Healthcare West, San Francisco, agreed. Were trying to be realistic here, said Dean, who was named the CHAs chairman-elect last week. He will succeed Sandra Bennett Bruce, president and CEO of 369-bed
St. Alphonsus Regional Medical Center, Boise, Idaho, who began a one-year term as CHA chairwoman June 17.
The newly released principles dont tie Catholic healthcare to any policy or politician, but set clear criteria by which emerging proposals will be judged, Dean said.
Anthony Tersigni, president and CEO of 61-hospital Ascension Health, the nations largest Catholic and private not-for-profit health system, said the principles lay a foundation for comprehensive reform to the nations piecemeal health policies. What we lack in this country is a healthcare policy, Tersigni said. What we have is a healthcare financing policy.