A Healthy Blog

Massachusetts health care — wonky, with a healthy dose of reality

GAO Report Points to Health System Reform Consensus and Disagreements

GAO Report Points to Health System Reform Consensus and Disagreements

September 10, 2007

Here's a new report from the Government Accountability Office (GAO) worth checking out -- click here: Health Care 20 Years From Now -- Taking Steps Today to Meet Tomorrow's Challenges. It's the account of a special consultative session organized by GAO Comptroller David Walker, which includes about 30 health policy luminaries from across the nation, including: Carolyn Clancy (AHRQ), Robert Reischauer (Urban Institute), Henry Aaron (Brookings), Richard Frank (Harvard Medical School), Anne Gauthier (Commonwealth Fund), Robert Greenstein (Center on Budget and Policy Priorities), John Iglehart (Health Affairs), Karen Ignani (America's Health Insurance Plans), Chip Kahn (Federation of American Hospitals), Ron Pollack (Families USA), John Rother (AARP), Alan Weil (Nat. Academy for State Health Policy), and others.

Here's the interesting part -- prepared statements and the extent to which they generated support or opposition: (the % indicates the percent who strongly agree or agree) --

1. A spending limit -- such as a percent of the federal budget -- should be used as a policy tool to control federal health care spending. 45% -- no agreement.

2. Fostering efficiency incentives at the individual patient level is an appropriate and effective way to moderate health care spending increases. 52% -- agreement.

3. Certain federal tax preferences for health care should be revised to encourage more efficient use of health care products and services. 97% -- strong agreement.

4. The federal government should impose constraints on the development and diffusion of medical technology. 75% -- agreement.

5. The federal government should revise its payment systems and leverage its purchasing authority to foster value-based purchasing for health care products and services. 90% -- strong agreement.

6. Direct-to-consumer advertising of prescription drugs should be limited. 78% -- strong agreement.

7. Steps should be taken to encourage individuals to assume more personal responsibility for their own health and wellness. 78% -- strong agreement.

8. Further importation of prescription drugs (beyond current levels) should be allowed. 71% -- agreement.

9. The federal government should ensure that all Americans are covered for basic and essential health care services. 96% -- strong agreement.

10. States, rather than the federal government, should take the lead in expanding access to health insurance for all residents. 20% -- no agreement.

11. The United States should continue to rely on employer sponsored health care coverage as the backbone of the U.S. system of coverage. 42% -- no agreement.

12. The federal government should assure that a health insurance market exists that adequately pools risk and offers alternative levels of coverage. 84% -- strong agreement.

13. A public-private entity should be created to assess and disseminate its findings and comparative and cost effectiveness of health care products and services. 97% -- strong agreement.

14. OECD health care measures (population-based, resource, and spending) are a valid guage of U.S. health care system performance. 68% -- agreement.

15. The federal government should take the lead in developing indicators (such as comparisons across regions, trends over time) to measure the U.S. health care system's outcomes and performance. 81% -- strong agreement.

16. The federal government should create financial incentives to expedite the use of information technology in health care, ensuring its interoperability and widespread adoption. 80% -- strong agreement.

17. National practice standards should be adopted by an independent body that includes key stakeholders. 84% -- strong agreement.

18. The United States should balance its health care research investments between new discovery and assessing comparative and cost effectiveness for new and existing medical interventions. 88% -- strong agreement.

Food for thought. Directions for action...Maybe?