WHEN IS too much too much, or too little too little when it comes to government interference? That's a question on everyone's mind with the election and Republican vs Democrat solutions for the economy, the war in Iraq and other issues. But this past month, in particular, it seemed to be a theme in Washington surrounding healthcare.
Case in point – the General Accountability Office said "enough already" in a recent study of federal oversight of nursing home care. The oversight, the surveys of nursing homes and the care itself were all not cutting it, the report said. Congress jumped on it, holding a series of investigations in May on how to bring oversight up to snuff, something the GAO has repeatedly warned needs to be improved. Better and more government interference is clearly needed here, the lawmakers said.
Yet when it comes to patient control of healthcare records, privacy activists are calling for less interference. Up on Capitol Hill on a regular basis, activist groups like the Coalition for Patient Privacy are trying to prevent any healthcare IT bills from passing without making sure that patients are in complete control of their health records.
The hot seat of this debate is electronic prescriptions. The industry wants this to move forward as soon as possible and would like to see a federal push in that direction. Many have called electronic prescriptions the tipping point to driving change in healthcare, lowering costs and bringing on the advent of electronic health records.
The battle over children's healthcare and Medicaid are battle zones as well, with the Democrat Congress pushing for less control from the Administration. Congress would like to successfully block federal efforts to cut Medicaid spending. This may be a case of big government calling for itself to back down.
The federal government intervened years ago when it set up the current Medicare payment method for physicians. Under this method, doctors will face a 10.6 percent pay cut July 1 unless there is a second intervention. The House Committee on Small Business held hearings in May to look at how the pay cuts will affect small practices.
The vast majority of physician practices are small businesses, according to the American Medical Association. And yes, says a recent Medical Group Management Association survey, many physicians – maybe as many as half – plan to cut back on treating Medicare patients if the cuts go through. Intervention is needed, doctors say. But this time, the right intervention to make payments fair and keep Medicare access opened to vulnerable seniors.
One thing is certain: U.S. healthcare is unsustainable in its current state, says a May GAO report on the long-term fiscal outlook. "The question is how and when the nation’s current imprudent and unsustainable path will end," the GAO said.
It's likely going to take government of all kinds – local, state and federal – intervening in big and little ways, and every kind of private and community effort and the effort of the individual to turn this around.