Industry leaders last week gave a thumbs up to the first in a series of confirmation hearings on Capitol Hill that will likely lead to the appointment of former Senate Majority Leader Tom Daschle to the nations top healthcare post. But they warn that, to date, details of any major health reform initiative remain scarce and any broad measure to do so could create some turf battles.
In front of the Senate Health, Education, Labor and Pensions Committee last week, Daschle said he would focus on cost, quality and access problems inherent in the U.S. healthcare system while realigning physician payment so that it puts a premium on prevention and wellness. He pledged to do this by working across party lines, which would allow for bipartisan input between the Democratic majority and Republicans, many of whom worry theyll be sidelined in the debate.
Its a clear nod that the native South Dakotan intends to fix what many consider to be a scattershot healthcare system.
The statements came during a largely ceremonial hearing on Capitol Hill, where Daschle faced few tough questions from former colleaguesmany of whom lauded the presumptive secretary for his thoughtful nature and ability to work with both parties. Indeed, Daschle will need that working relationship in order to push through any reform effort. While HHS headquarters in Washington is just a few minutes walk from the Capitol, ideologically it has seemed much farther.
Jack Lewin, chief executive officer of the American College of Cardiology, gave Daschle high marks for his testimony. I was thinking that this man has a good vision and handle on where healthcare needs to go, he said.
Physician groups especially homed in on Daschles comments about payment reform, a topic certain to come up early in the new session of Congress because of an expiring Medicare physician payment fix. I couldnt feel more strongly that the SGR system just isnt working right, Daschle said. Lawmakers have annually grappled with the complicated sustainable growth-rate payment formula.
Showing a deft knowledge of healthcare, Daschle also said he would bolster the ranks of primary-care doctors. Under his vision of a reformed healthcare system, primary-care doctors, internists and nurses would have a higher-profile role working with patients and families to stay healthier rather than be treated when they are sick.
The Health Resources and Services Administration has projected a massive drop in the ranks of primary-care doctors. In little more than a decades time, HRSA said that the nationwide supply of doctors will be about 271,440, or 66,000 fewer than is expected to be needed, about a 20% gap.
It starts with the realization that our system works through incentives, Daschle said, adding that the current system offers more incentives for doctors to choose a subspecialty rather than primary care. Under Daschles vision for reform, primary-care doctors would be the first in line for working with individuals and families to stay healthy rather than get treated when theyre sicker.
Were very, very encouraged to hear the emphasis he put on primary care, said Robert Doherty, a senior vice president at the American College of Physicians, a membership organization representing internal medicine.
Daschle also said that he would focus on rural health and the Indian Health Service.