The 2003 Medicare Modernization Act the Bush administration pushed through--it also created Part D--included a provision that established a "Citizens' Working Group" to study the American health care challenge and report back to the President and the Congress with suggested solutions.
Their mission was to "promote a public debate" on solutions to the cost, coverage, and quality challenges we face. The group included people from all the relevant stakeholders including doctors, hospital administrators, union leaders, benefit managers, and others. They held a number of hearings around the country for a year and issued their conclusions this past September.
Their recommendations fell far short of offering any kind of comprehensive reform proposal. Instead, the group's most specific proposal was to set up an independent commission to create a core set of benefits that every American should have access to by 2012 as a first step toward reform they never defined in any detail.
Their key recommendations:
1: Establish Public Policy that All Americans Have Affordable Health Care
2: Guarantee Financial Protection Against Very High Health Care Costs
3: Foster Innovative Integrated Community Health Networks
4: Define Core Benefits and Services for All Americans
5: Promote Efforts to Improve Quality of Care and Efficiency
6: Fundamentally Restructure the Way End-of-Life Services are Financed and Provided
Perhaps most telling is this from the first recommendation to establish affordable care for everyone, "The Working Group is proposing immediate action to establish the policy that all Americans have affordable health care." There were no details on how to do it, how much it would cost, and how it would be paid for.
Speaking for the administration, HHS Secretary Leavitt rejected the notion of a core set of benefits instead reaffirming the administration's focus on consumer choice and options rather than benefit mandates.
The "Citizens' Working Group" wasn't able to come to any meaningful proposal on health reform. They simply said we have a big problem and we need a comprehensive solution. Now, there's a headline.
A year of work, tons of hearings, and all they can tell us is that we have a huge problem we need to fix?
The Bush administration was right to reject this flimsy piece of work. But that doesn't make them heroes. For six years they have virtually ignored America's health care crisis with half-hearted and flimsy proposals of their own.
In the end, I guess the lesson is that health care reform is really hard. Anyone who wants to effectively tackle health reform is going to hit some very uncomfortable issues head-on--and spend some big time political capital.
Neither the Bush administration or the "Citizens' Working Group" appears to have that kind of gumption.
See our recent post: A Health Reform Plan That Can Work.
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