'Roll call' solicits strong opinions on health reform

Roll Call published a special section today that pulls together opinion pieces from 20 major players from all corners of the health care debate, including Tom Daschle, Michael Tanner, Dick Gephardt and Tommy Thompson and Newt Gingrich and Jim Frogue.

Tom Daschle writes that "we might be willing to accept" the rising costs of health care "if we were getting great value from the investment. But the truth is that the quality of our health care is actually declining despite of all the technological innovations that we have witnessed in recent decades." He proposes several solutions to fix the "sea of mediocrity" in American health care. First, "build on the system that we have," because "radical change cannot be successful." Second, create a "comprehensive plan to address cost, access and quality" rather than taking an incremental policy approach. Third, focus on "modernization," including health information technology and "evidence-based medicine and best practices." Forth, "invert the pyramid" of care by changing "the paradigm from illness to wellness." And fifth, ensure coverage "for all Americans" (Daschle, 6/8).

Michael Tanner, a senior fellow at the Cato Institute, writes that "universal health insurance does not mean universal access to health care. In practice, many countries promise universal coverage but ration care or have extremely long waiting lists for treatment." He also warns of the potential costs. Health care overhaul, Tanner says, will never be a "free lunch" but "many in Congress naively think that if we simply expand coverage, cost control will take care of itself." He adds that in other countries, there is "evidence of a growing shift from public to private provision of health care. If many of the proposals in Congress would push us toward more of a European-style system, the trend in Europe is toward a system that looks more like the U.S." (Tanner, 6/8).

Democrat Dick Gephardt, former House Democratic Leader, and Republican Tommy Thompson, former HHS secretary, write that they "share optimism about the possibilities for health care reform this year." They advocate for a "robust investment in prevention of chronic disease" and for changing the "incentives for both patients and providers" (Gephardt and Thompson, 6/8).

Jane Delgado, head of the national Alliance for Hispanic Health: "We cannot continue to accept the premise that there is more waste in health care than in any other sector and that we are spending too much on health care ... If we are going to achieve meaningful health care reform, it is going to require a new discussion of our values as a country. It is also going to require one of the least favorite things of Congress and voters, new taxes. However, if the discussion is honest and reform is based on American values of fairness, equity and compassion, we will agree to make that funding happen."

Newt Gingrich, former Speaker of the House, and Jim Frogue, state project director of Gingrich's Center for Health Transformation, write that "fighting health care fraud" is "one key area where Democrats and Republicans should be working together." "To make serious strides in the fight against fraud," they write, lawmakers should "immediately make public all Medicare and Medicaid claims data, but only in a manner that vigorously protects patient privacy." Second, "Congress should ensure that Medicare patients with the most extreme outlier claims have access to the newest and best disease management plans," which would "do a much better job" of combating fraud. And third, Congress should expand the "scope, use and distribution of the HHS OIG exclusion lists – a list that publicizes those individuals convicted of health care fraud" (Gingrich and Frogue, 6/8).