More than 2,400 doctors, nurses and health advocates sent a letter this week to the Department of Health and Human Services Secretary Kathleen Sebelius protesting the Institute of Medicine's recommendations to HHS on how to determine an essential health benefits package as mandated under health reform.
The letter, written and distributed by the Physicians for a National Health Program (PNHP), cited apparent conflicts of interest among the IOM committee members while also objecting to the concept of creating a benefits package that aims for "premium target," a strategy the PNHP contends would lead to watered down and "skimpy" coverage that would "sacrifice many lives and cause much suffering."
The PNHP advocates including a list of medically necessary benefits instead of those that would hit a price target and urged the administration to reject the recommendations.
"The IOM panel endorsed insurance coverage similar to that offered by small employers rather than the more comprehensive coverage offered by large employers," said Danny McCormick in a press release about the letter. McCormick is an internist, assistant professor at Harvard Medical School and former IOM fellow who helped circulate the letter. "The recommendation was widely viewed as a victory for the health insurance industry, which has long opposed mandating comprehensive benefits."
Further, the letter stated, the IOM committee comprised members with inherent conflicts of interest including members such as Sam Ho, executive vice president of UnitedHealthcare; Leonard D. Schaeffer, director of the biotechnology company Amgen and former chairman and CEO of WellPoint (Schaeffer's family foundation donated $2 million to the IOM in 2010); as well as executives from 3M Health Information Systems, a medical supplier, Milliman Inc., an actuarial consulting firm with close ties to the insurance industry, and The Blackstone Group, a private equity firm with major healthcare interests.
"Many committee members' strong ties to the health industry violate the guidance offered in a 2009 report issued by the IOM which recommended that those with industry conflicts of interest should generally be excluded from such panels," said Steffie Woolhandler, MD, in a statement. Woolhandler, a professor of public health at the City University of New York and visiting professor of medicine at Harvard Medical School, served as an IOM fellow in 1990-1991.
The letter from PNHP comes nearly two months after IOM first released its recommendations on how HHS should go about designing an essential health benefits package, a key provision of the Affordable Care Act that will also help guide insurers on insurance products to be offered on the state's health insurance exchanges.
"Before we forward a proposal, it is critical that we hear from the American people," said Sebelius in an October statement after the IOM released its recommendations. "To accomplish this goal, HHS will initiate a series of listening sessions where Americans from across the country will have the chance to share their thoughts on these issues."
HHS has not cited a specific timetable for announcing what will be included in the essential health benefits package, though it has concluded the public meetings and the comment period will be ending soon. Woolhandler said the letter was submitted to HHS now because it wanted to the letter to be entered into the public comments.