Health policy in this country lacks direction because of a shortage of decisive leadership in both the public and private healthcare sectors.
Healthcare's Waffle House
Resolute leadership is becoming difficult to find in healthcare circles these days
The past few weeks have witnessed an unprecedented amount of waffling on important healthcare topics that only feeds the belief that if you just shout loud enough, the object of your ire will back off their position rather than stand firm. The fact that this is an election year only makes things worse.
The latest waffle was the decision last week by HHS to postpone the scheduled Oct. 1, 2013 compliance date for the industry to switch to the ICD-10 system of diagnosis and procedure codes. Never mind that the rest of the industrialized world has been using ICD-10 for two decades and that U.S. providers have known about the switch for years, organized medicine didn't like it and that was that. Too costly, too burdensome, too complicated, too fast were among the reasons cited for pushing ICD-10 compliance further into the future. HHS caved under the pressure, which surely will reappear with added vigor when the next compliance deadline comes up.
While HHS was folding, so too was the legislative branch of the federal government on finding a permanent replacement for the problematic Medicare sustainable growth-rate formula for paying doctors. Under the formula, physicians would have been subject to a 27.4% reduction in their Medicare payment rates on March 1. But rather than dealing with the problem, lawmakers again postponed a decision by extending the SGR through the end of the year with the pay cut now scheduled to take effect on Jan. 1, 2013. We've lost track of the number of times Congress passed the buck on this one. But you can be sure that come December, we'll be writing the same story but only plugging in different dates.
Back to the executive branch. In January, HHS released a final rule implementing a provision of the Patient Protection and Affordable Care Act that requires insurers to provide coverage for preventive-care services to enrollees with no co-payment or deductible. The rule required all employers to provide that coverage through their carriers to their employees, including coverage for contraceptives. The rule gave an extra year to religious employers, including Roman Catholic hospitals, to comply with the rule if their religious doctrines opposed the use of contraceptives.
The backlash from Catholic bishops, conservative groups and many Republican members of Congress was vocal and immediate. Twenty-one days after the final rule was unveiled, President Barack Obama backed off, announcing that faith-based employers would not be required to pay for contraceptive coverage as part of the benefits package offered to their employees. Instead, the employers' carriers would be required to offer that coverage free of charge to any employee who wanted it.
Making Obama's reversal on birth control seem lead-footed was a private-sector turnabout from the Susan G. Komen for the Cure organization. On Jan. 31, the Associated Press broke the news that the nation's leading breast cancer organization decided to stop giving money to Planned Parenthood, the nation's largest provider of abortion services, for breast-cancer screening and related services. The backlash again was immediate and vocal, this time from many women's groups, liberal organizations and Democratic members of Congress.
Three days later, Komen reversed itself and said it would continue to provide grants to Planned Parenthood.
We support effective technology, fair payment for services, equitable benefits packages and prevention and wellness. We also support the necessary leadership to see that these goals become a reality. We need leaders in healthcare who have the courage of their convictions and who will see their ideas through to a successful conclusion no matter what the political or public relations cost.
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