Friday, January 19, 2007

PA Governor Unveils New Health Care Proposals

On January 17, 2007 -- one day after his re-inauguration for a second term as Governor of Pennsylvania -- Edward G. Rendell announced his administration's new program that would address the quality & cost of health care services in Pennsylvania, and would increase health care coverage to all its residents.

A Press Release (PDF, 4 pages), dated January 17, 2007, entitled Governor Rendell Unveils Historic “Prescription for Pennsylvania” to Provide Access to Affordable, Quality Health Care for All Pennsylvanians, announced the state government's initiative regarding health care coverage in the Commonwealth. It was posted on the site of the Governor's Office of Health Care Reform:

Building on his successful initiatives to expand access to health care including Cover All Kids and PACE/PACENET, Governor Edward G. Rendell today offered a sweeping and bold “Prescription for Pennsylvania” to increase access to affordable health care coverage for all Pennsylvanians by lowering costs, improve the quality of care available in the state and bring health care costs under control for employers and employees.

“We can no longer stand by while health care costs spiral out of control, leaving some 767,000 adult Pennsylvanians without the basic health care they need and creating a drag on our economy,” Governor Rendell said. “It is no longer a question of whether we can afford to act – the cost of inaction is far greater; both in terms of individual health consequences and from the increasing burden on taxpayers.

“Every year, Pennsylvania businesses, consumers and taxpayers pay at least $7.6 billion for unnecessary and avoidable health care costs. That is money that isn’t improving the quality of care we receive, nor making Pennsylvanians healthier. It doesn’t make sense. We should be redirecting that money to fix our broken health care system.”

The Press Release provided an outline of the proposal, but noted that its implementation would require state & federal action:
Specific components of Governor Rendell’s initiative will require legislative and federal approvals. If the necessary approvals are timely, the CAP program is expected to begin operating in January 2008. The financial aspects of the plan will be further detailed when Governor Rendell announces his budget plan for the 2007-08 state fiscal year in early February.
The Governor's Office followed the initial Press Release with another, dated January 18, 2007, entitled Governor Rendell's "Prescription for Pennsylvania" Will Enhance Access to Quality Health Care in a Variety of Settings. These are the advocated advantages of the proposed program, which the second Press Release addressed in more detail:
  • Enable nurses, advanced nurse practitioners, midwives, physician assistants, pharmacists, dental hygienists and other licensed health care providers to practice to the fullest extent of their training and skills.
  • Promote incentives for health care providers who offer services in the evenings and on weekends, which will help to discourage consumers from seeking emergency room treatment for routine medical concerns.
  • Expand access to care by addressing urgent workforce needs in rural regions.
  • Increase the diversity of the health care labor force in an effort to improve the provision of care to historically underserved communities.
  • Expand access to care by creation of "Cover All Pennsylvanians" (CAP), a program offering affordable basic health coverage to small businesses and the uninsured through the private insurance market.
  • Increase accountability of everyone in the health care system -- consumers, hospitals and other care providers.
  • Improve patient safety by eliminating hospital-acquired infections and targeting avoidable medical errors.
Reactions were immediately posted online by various key "stakeholder" organizations involved in Pennsylvania health care, including:
News reports about the announcement provided background, some public reactions, and questions:

Rendell's plan follows prior initiatives in the states of Massachusetts, California, Maine and Vermont, but it would go beyond universal insurance coverage, he says:
"I believe ours is the most comprehensive of any of the five states that have announced plans," Rendell said.

"It's a health plan that will benefit all Pennsylvanians, all Pennsylvania businesses, and all people who provide health care services."
On the same day as the Governor's announcement, January 17, 2007, an article was posted on Pennsylvania State University's website that highlights the national problems in healthcare. See: The Medical Minute: Medical care costs -- Are Americans getting their money's worth?, by John Messmer, of the Penn State Family and Community Medicine, Penn State Milton S. Hershey Medical Center, Penn State College of Medicine. Following are some excerpts:
Health care costs a lot in the United States -- somewhere around $6,000 for every person annually. That’s what Americans as a nation paid in 2004 for everyone’s medical care when it’s all added together -- a total of just under $2 trillion in government and non-government spending. * * *

What does all that money buy? About a third is for hospital-based services, and a fifth is for services provided by physicians and related health-care providers. Approximately one-tenth is for dental care, and another tenth buys pharmaceuticals. The remainder is divided among administration, home health, public health, investment and other costs. It’s about 16 percent of the gross national product.

Approximately 42 million Americans have no health insurance. The $2 trillion we spend includes the cost of care for these uninsured who enter the health-care system with advanced medical problems. About a third of the $2 trillion is paid by the federal government (Americans' tax money); a third by private insurance companies (premiums paid by employers or by employees); and of the remainder, state and local government and out-of-pocket payments comprise the largest shares.

Are Americans getting their money's worth? * * *

Pundits and politicians point to various "causes" of the problem. But the nation's health-care delivery is a complex system with so many things out of balance, just about every part must be addressed in order to fix it, and everyone involved will be required to sacrifice something.

“Government alone cannot –- and should not –- attempt to solve every problem facing our state’s health care system.” -- Governor Edward G. Rendell

Update: 01/24/07:

See Governor Rendell's two Press Releases, both issued January 24, 2007, regarding the Rx for Pa initiative: