A health care commission empaneled by U.S. Sen. Chuck Hagel presented its recommendations for reform of America’s health care system at a news conference at Creighton University on Friday.
Hagel formed the commission last February to focus on developing recommendations for an accessible, affordable, sustainable and quality health care system for the 21st century.
The commission brought together key health care professionals and leaders from Nebraska and beyond, including UNMC’s Dennis Goeschel, M.D., Keith Mueller, Ph.D., and Virginia Tilden, D.N.Sc. Hagel asked the commission to provide him with recommendations within a year.
“I hear about health care issues from Nebraskans every day. It is an issue that touches the lives of every American. I am grateful to these highly-respected health care professionals who have volunteered their time, energy and expertise to this project over the past 11 months,” Hagel said. “I asked them to give me their most honest assessment of what should be done to reform our health care system and that is what they have done. The commission has developed creative and important ideas to help meet America’s health care needs in the 21st century. I look forward to reviewing their recommendations and using them as a basis from which to craft legislation that I intend to introduce in this Congress.”
Charles Marr, founding CEO of Alegent Health in Omaha, served as the commission’s chairman.
“I thank our talented and dedicated commission members who have created a new vision for accessible and sustainable health care in America,” Marr said.
The commission focused on all facets of health care, including health care costs and access to reliable health care. The commission met eleven times in order to produce the report presented to Hagel.
The Hagel Commission formulated the recommendations summarized below:
- Mandate a basic health care plan for all Americans that emphasizes patient-centered care focused on prevention, health promotion, and coordinated care across the life-span. Often called a “medical home,” this model integrates all aspects of the care continuum and focuses on care coordination and active disease management.
- Address the problem of attracting, developing, educating, and retaining health care providers by designing a funding mechanism to support workforce development and by creating innovative incentives to attract practitioners to high-need areas.
- Focus on quality and safety as key components in American health care. Ensure that all participants are accountable for using evidence-based guidelines and are rewarded for positive outcomes. Create a secure, universal, individual standardized electronic medical record to facilitate this transformation.
- Emphasize the vital role of public health in improving health, life expectancy, and quality of life. Expand public health infrastructure and services.
- Decrease the practice of defensive medicine by establishing mandatory dispute resolution procedures that address malpractice claims under the basic health care package.
- Give all Americans free choice in the purchase of insurance plans, and give consumers clear information in billing and coding for health services.
- To finance the new system, establish a public-private partnership that includes employers, employees, and government support. The new system will be funded by eliminating inefficiencies and duplication in American health care today; a redesigned Medicare FICA tax; state contributions that are now directed toward the Medicaid program; continued federal funds presently committed to Medicare, Medicaid, and other national health plans; and a national tax on alcohol and tobacco consumption.
To carry out these recommendations, the Hagel Commission proposes creating an independent Health Care Transformation Commission patterned after the Federal Reserve Board, as outlined in this report. This body also will make binding resolutions, carry out ongoing modifications and updates, and evaluate changes to national health care policies. The president and the Senate will make bipartisan appointments, and commissioners will serve staggered terms.
Conclusion
To redesign health care, policy makers must develop integrated systems to improve the continuity of care for every American. The Hagel Health Care Commission believes this challenge can best be addressed through patient-centered primary and specialty care. Payment and delivery systems must also be reformed through an active partnership of consumers, providers, insurers, suppliers, and government. To complement the transformation, the national public health system should receive additional emphasis and national coordination. Improving our capacity to recruit, educate, and retain health professionals is essential to the new system.
The Health Care Transformation Commission (HCTC), an independent federal agency modeled after the Federal Reserve Board, will be the vehicle for managing the health care transformation process. This non-political commission will develop the basic health plan; establish national standards and protocols for health information technology; assess new medical technology; and will set national standards for best practices, data collection, quality assessment, and research.
We believe that rising health care costs result, in part, from a lack of clear national policies regarding health care delivery and financing. Clarity and consistency in federal health care policy are essential first steps in addressing health care cost containment. The Hagel Commission concludes that the best way to finance the transformed health care system will be through the private and public sectors. Private sector premiums will be paid by all employers and employees on a predetermined basis. The public sector will provide premium subsidies to help employees and individuals based on federal poverty guidelines. Public sector funding will come from the sources noted in our recommendations. We recognize the problems caused by defensive medicine and believe that a mandatory dispute resolution procedure should be adopted nationally.
The Hagel Commission believes we can retain individual choice of plan and providers; at the same time, the delivery system can become more accessible and understandable. Consumers will be able to expect and receive coordinated quality care in the most appropriate setting, and ever-increasing health care costs will be restrained.
While this new system will require greater accountability on the part of all, it will be built on the uniquely American strengths of private and public cooperation and will provide efficient, patient-focused care for all. In the overall transformation of U.S. health care, the Hagel Commission urges policy makers to combine the American values of social responsibility, choice, and individual accountability with a passionate commitment to quality. Revitalizing a sense of community and interest in the common good can transform our health care system for the 21st century.