Gov. Ed Rendell will be sworn in for his second term on Jan. 16. As the curtain rises on Act Two of his tenure as Pennsylvania’s chief executive, the governor confronts some imposing challenges.

Most of these are left over from the first term, like property-tax reform, mass transit, highway funding and the nagging Medicaid deficit. * * *

Rendell brings political resources to the table that distinguish him from most other re-elected governors. He is at the apex of his power. He won re-election with a huge 60 percent of the popular vote, and his popularity with Pennsylvanians is the highest since he first assumed the governorship in 2003.
An opinion letter published here in the Morning Call earlier, on December 16, 2006, entitled "A Good-Government Agenda for State Legislators", suggests eight significant issues. The writer, John F. Brinson of Weisenberg Township, is a producer of ''Pennsylvania Crossfire'', which appears weekly on cable TV. His named issues that affect seniors include:
  • School property tax reform. The worst possible way to fund public education is real estate taxes, which are inherently unfair, complicated, difficult to administer, and do not consider ability to pay. I favor elimination of the property tax by increasing the state personal income tax. * * *
  • Pension reform. Pennsylvania is bankrupt, but no one knows it. All our local governments and school districts are bankrupt, but no one knows it. The cause is the absurdly rich defined-benefit pensions for public employees, which are beyond the imagination of workers in the private sector. Funding these outrageous plans in the future will be impossible. We should demand an end to defined-benefit plans and give all public employees defined contribution plans. * * *
  • Reform Medicaid. Medicaid is the most expensive welfare program in Pennsylvania. The nation spends more on Medicaid (state and federal combined) than it spends on national defense! Medicaid should offer a choice of plans, and there should be deductibles and copayments — not large, but enough to make beneficiaries think before going to the hospital for any and every thing.
The Governor himself spoke recently about his political agenda. In an Associated Press article published on December 11, 2006, entitled "Rendell says he aims to cut health care costs in 2007", it was reported as follows:
Gov. Ed Rendell said Monday that he will roll out a plan to lower health care costs by forcing hospitals and other care providers to be more efficient and make fewer mistakes.

The plan, to be unveiled fully in January, will probably spark broad complaints from the health care industry, Rendell predicted. For instance, he said, he wants to rewrite rules to allow nurse practitioners to play a greater role in patient care and create new regulations designed to guard against hospital-acquired infections.

"The test for us is, are we going to have the intestinal fortitude to look down the barrel of the special interests and say, 'Uh-uh guys, not this time, health care is too important of an issue for the people of Pennsylvania,'" Rendell said during a traditional end-of-year interview with reporters.

The Governor specifically addressed his new expectations for the state-administered Medicaid program:

In Medicaid, the health insurance program for the poor and disabled, the state will start paying health care providers for keeping patients healthy, instead of for simply treating a patient, Rendell said.

Rendell's health care concerns will involve nurse practitioners, infection control at hospitals, and the medication benefit program for state employees.

The Pennsylvania Medical Society likely will be involved in these agenda items.

[T]he society, [a PMS spokesman] said, will want to take part in discussions to help decide what is best for patients.

"We want to be a part of the plan," Moran said. "You're really talking about redefining the health care team because costs are getting high and patient safety is a concern."

On the same day that the Governor spoke with reporters, December 11, 2006, a study was released, as reported by UPI in an article entitled, "Hospital-quality factors ID'd in study". The study concluded:

A high number of registered nurses, technology use and non-profit status of a hospital are key determinants of quality of care."

Hospitals with those characteristics provided better care to patients with congestive heart failure, heart attack and pneumonia based on 10 performance measures, according to a study by Harvard Medical School researchers appearing in the Dec. 11 Archives of Internal Medicine.

If you are interested in seeing an evaluation of the current quality of health care provided to Medicare patients in Pennsylvania, see the annual report entitled "Annual Medical Services Review Report". It was prepared by Quality Insights of Pennsylvania, the Medicare Quality Improvement Organization, under contract with the Centers for Medicare & Medicaid Services (CMS). The report, covering the timeframe from August 1, 2005, through July 31, 2006, is found online here.