By Sen. Judd Gregg
May 02, 2008 06:15 am When you spend more you expect higher quality, whether it's a house, a car or a meal at a restaurant. However this expectation does not hold true for health care. More tests, more specialists and more money do not always lead to better quality. How can this be? Dartmouth's Institute for Health Care Policy and Clinical Practice continues to provide health care experts and policy makers with important new studies on the cost and quality of health care across our nation. In the 2008 study, "Tracking the Care of Patients with Severe Chronic Illness," Dartmouth found enormous variation in the standard of care between different regions of the nation. The researchers focused on patients with severe chronic illnesses during their last two years of life and showed there is a wide discrepancy on how much is spent on health care throughout the nation. More importantly, the variations didn't correspond to the types of illness, stage of treatment, or better quality of health care and health outcomes; rather, the discrepancies in costs were a result of how many services the hospital or health care system offered. Simply put: spending more money didn't produce better health care. For example, take the comparisons of costs between two of our country's top medical centers — the UCLA Medical Center and Mayo Clinic in Minnesota. Health care spending at UCLA over two years averaged more than $93,000, while at the Mayo Clinic it averaged just over $53,000. However, this difference in cost did not improve patient outcomes or increase the quality of care. Instead, it essentially purchased additional days in the hospital and more visits to physicians. If the patient does not benefit from such aggressive treatments, then why keep paying such high Medicare prices for unnecessary services? Imagine the savings to our $2 trillion health care system if every hospital in the nation was as efficient as the Mayo Clinic or the Cleveland Clinic, another high performer with low costs. Medicare alone has an unfunded liability of $36 trillion over the next 75 years, and by employing this type of efficiency now we could also slow the runaway growth of Medicare and Medicaid spending, two of programs that are the leading cause of our nation's impending fiscal crisis. Obviously, there are no simple solutions to slowing the pace in the growth of health care costs. We must also be mindful that health care cannot be delivered in a one-size-fits-all package because everyone is different and can require different health care solutions. Yet, there are approaches that must be taken to improve some underlying deficiencies in our health care system to improve access, quality, and curb the massive wall of debt our nation is heading for if we don't work together in a bipartisan matter to reform the broken system. For example, we should start by using the information already available to us, collected everyday by the federal government to learn how health care is delivered and how much it costs. I have proposed bipartisan legislation called the Medicare Quality Enhancement Act that would help achieve the goal of improved health care. Businesses and health insurance plans in the private sector already utilize their own data to compare and examine the cost and effectiveness of the care their workers and beneficiaries are receiving. This bill expands that research effort by allowing highly qualified organizations to access Medicare data to determine more effective health care solutions while making it more affordable, and at the same time, places a premium on the privacy and security of Medicare beneficiaries. These reports can be requested by private sector organizations to measure health care quality and costs to allow consumers to make more informed decisions. The administration also agrees with this idea, and recently proposed similar legislation to do just that. We must also find ways now to curb the projected $66 trillion in unfunded entitlement spending our nation faces as a result of the retirement of more than 70 million baby boomers. Potential solutions must be bipartisan, such as the one offered through the Bipartisan Task Force for Responsible Fiscal Action, which I introduced with Senate Budget Committee Chairman Kent Conrad. The 16-member task force is comprised of an equal number of Democrats and Republicans, and requires solutions sent to Congress to be fast tracked through the process and acted on. Affordable and accessible health care is important for leading a quality standard of life; yet rising health care costs threaten to strangle the availability and quality of health care, as well as the financial security of future generations. Without reform, we break the cycle of prosperity our generation has inherited, again proving the theory that more is not better as we hand over more debt without a better lifestyle to our children and grandchildren.
Sen . Judd Gregg, R-NH, is serving his third term in the United States Senate. ><p>
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