President's Message

Three Goals for Health Care Reform

There are many “interested parties” in the drive for meaningful health care reform: physicians, patients, hospitals, insurers, employers, and elected officials. The fact that each group has vested interests in the reform process and outcome means that one group often comes into conflict with one or several others. When stakeholders square off and squabble, it becomes difficult for meaningful reform to emerge. This is especially true when the issues are as complex as those surrounding health care reform.

So, how can we all work together effectively? One way is to identify goals that all stakeholders can agree on -- and to remember these objectives always, especially when partisan interests threaten to derail negotiations. Recent conversations with leaders from the hospital and health insurance communities have led me to the following three goals on which I think all stakeholders can agree:

• Improving patient safety
• Continuously improving the quality of medical care
• Carefully controlling costs

The use across all 50 states of weight-loss surgery guidelines developed in Massachusetts is a great example of what happens when stakeholders put aside their individual agendas and place patient safety and quality first.

I’m writing this message on the same day the Centers for Medicare and Me dicaid Services reported that total U.S. health care spending in 2004 ($2 trillion) accounted for 16 percent of the gross national product. I refer to careful cost control in the third goal because it is unreasonable to expect the national tab for health care to decline from present levels any time soon. Baby boomers are becoming Medicare beneficiaries, new medical technology continues to emerge, and the price tag of new prescription drugs keeps rising.

Cost control requires cooperation and compromise among all stakeholders. But that does not mean the imposition of draconian reimbursement cuts on the pro vider side or “cost shifting” that makes health care unaffordable for consumers. Keeping the goals always in our sights can help us overcome this stubborn dollars-and-cents dilemma regarding health care reform.

Physicians must lead the way in determining what “quality health care” means. We must continue putting patients first and never flinch from our commitment to continuous improvement and sensible, evidence-based utilization of resources.

Whenever anyone asks you what physicians stand for regarding health care reform, simply say, “improved patient safety, continuous improvement of quality, and careful cost control.” No one in their right mind will disagree with you!

– Alan M. Harvey, M.D., M.B.A.