Voters Weigh in Early

The Hospitalist. 2007 November;2007(11):

November 1, 2007|The Hospitalist

A poll by the Kaiser Family Foundation in August found that healthcare is the top domestic issue that the public wants presidential candidates to address.

Republicans and independent voters ranked healthcare second only to Iraq in the poll, while for the first time, Democrats ranked the two issues as equally important for the candidates to discuss as they campaign.

With more voters interested in changes to American healthcare—which is really shorthand for affordable access to health insurance coverage—the presidential candidates are also showing interest. Sort of.

Some, including John Edwards, Barack Obama, Hillary Clinton, and Mitt Romney, have a broad plan or opinion in place. Others, such as Mike Huckabee and John McCain, have not yet shared a plan.

As the election progresses—or even after a new president is sworn into office—will we see any real changes to healthcare access? “There has to be [some change],” states Bradley Flansbaum, DO, MPH, chief of hospitalist section at Lenox Hill Hospital in New York, N.Y. “We’ve reached a tipping point. You can’t continue to play kick the can.” The impetus for change, Dr. Flansbaum believes, will not be public opinion so much as money.

“I think that we’re reaching a critical mass, and that premiums will drive the change,” he predicts. “Employers can’t afford insurance benefits any more, and now that employers are changing plans and employees are paying more and faced with higher premiums, I think the house of cards will collapse.”

Laura Allendorf, SHM’s senior adviser for advocacy and government affairs, agrees change is in the air.

“I do think there are better opportunities for action than there have been in the past,” she says. “Various polls show that healthcare [access] is an important issue. That’s why so many candidates are developing proposals on this, or already have a proposal.” She adds, “A U.S. Census Bureau report just came out showing an increase in the number of unemployed—this will lend pressure for policymakers.”

Policy Points

Number of Uninsured on the Rise

According to the Census Bureau, the number of people in the U.S. without health insurance coverage rose to 47 million in 2006, or 15.8% of the population, up from 44.8 million, or 15.3%, in 2005.

New Hospital Discharge Notices

As of July 1, CMS requires hospitals to issue a revised version of the “Important Message from Medicare” that fully explains patients’ discharge rights to patients, within two days of admission. The CMS Web site offers information to help hospitals and physicians comply with the new procedures; you can review this information online at www.cms.hhs.gov.

New Head for Joint Commission

Physician Mark R. Chassin, MD, MPP, MPH, will take over as president of The Joint Commission effective Jan. 1. A board-certified internist who practiced emergency medicine for 12 years, Dr. Chassin is the Edmond A. Guggenheim professor of health policy and chairman of the department of Health Policy at Mount Sinai School of Medicine, New York City, and executive vice president for excellence in patient care at The Mount Sinai Medical Center.

Another Pay Cut Slated for ’08

You may recall that a scheduled 5% reduction in Medicare physician payments was narrowly averted last year. Unfortunately, that was merely a temporary reprieve—a 10% reduction is slated for physician fees in 2008.

While SHM and other healthcare associations lobby Congress to avert this cut, you can contact your representatives on Capitol Hill and ask them to take action. Visit SHM’s Legislative Action Center online at www.hospitalmedicine.org/beheard. —JJ

Where Will the Trail Lead?

Campaigning for the 2008 election is in full swing, and no one is surprised the candidates lack firm or detailed opinions on healthcare access. But what can we expect to see in the next year of campaigning?