Next year, a new president will take the White House and likely will be the one to lead the United States toward much-needed healthcare reform. What does the near future hold? What should hospitalists know about each candidate’s healthcare policies and proposals? Here, a hospitalist and a government advocate for hospitalists each weigh in.
Are the Times a-Changin’?
Laura Allendorf, SHM’s senior adviser for advocacy and government affairs, keeps a close eye on healthcare legislation, values, and trends in Washington, D.C. She predicts that regardless of which candidate takes office in 2009, change is coming fast.
“Healthcare will definitely be a top priority for the new administration … regardless of who wins the White House,” she says. “There’s been an unprecedented level of discussion already. Congressional committees have already held hearings to prepare for changes next year. They’re laying the groundwork now.”
However, not everyone agrees that we’ll see healthcare reform so soon: Bradley Flansbaum, DO, MPH, chief of hospitalist section at Lenox Hill Hospital in New York City, believes other major issues, such as the slow economy and the war in Iraq, may take precedence.
—Laura Allendorf, SHM senior adviser for advocacy and government affairs
“There are a lot of things on the agenda in Congress right now,” he points out. “I’m not sure how fast [healthcare reform] will really happen.” He says regardless of which man (Barack Obama or John McCain) wins, “he will have two or three top priorities as soon as he takes office—if healthcare reform is one of those priorities, some changes will happen.”
However, the business of Washington still can get in the way of a new administration. Dr. Flansbaum points to a House bill (HR 6331) that requests a delay in implementation of the Medicare competitive bidding program for durable medical equipment. “Lobbyists have sway over what legislators do in Washington, D.C.,” he notes. “Just because Obama or McCain come into office doesn’t mean those lobbyists will go away.”
Despite the forces against change, each candidate is touting major changes to healthcare access.
McCain and Tax Credits
Republican candidate McCain has released a healthcare plan based on instituting a federal tax credit to be used by individuals to purchase their own health insurance—regardless of whether they are covered (or can be covered) through an employer or through the non-group market.
His plan would replace a tax break for those who receive health insurance from their employers with a refundable tax credit of as much as $2,500 per individual and $5,000 per family, to be used for buying private coverage of their choice.
McCain’s plan proposes compensating physicians and hospitals based on performance, including tying Medicaid and Medicare reimbursements to results. His plan also includes ideas for containing healthcare spending by better treating chronic diseases, such as diabetes and heart disease.
“I believe that the best way to help small businesses and employers afford health care is not to increase government control of health care but to bring the rising cost of care under control and give people the option of having personal, portable health insurance,” McCain has said. He added that his proposal would allow individuals to retain their health insurance “even when they move or change jobs.”