Monday, June 1, 2009

Stakeholders Provide 28 Pages of Detail on How to Save $2 Trillion Dollars--And They Did it With a Straight Face!

America's Health Plans (AHP), the American Medical Association (AMA), the American Hospital Association (AHA), The Pharmaceutical Research and Manufacturers Association (PhRMA), the Advanced Medical Technology Association (AdvaMed), and the Service Employees International Union (SEIU) have detailed their plans to "do our part" toward achieving the administration's goal of saving $2 trillion in health care costs over the next ten years.

Each of these stakeholders has offered, in their own section of the document, what they contend will be savings.

For example, AHP outlines a series of steps including asking the federal government to enforce rules for information exchange to save on administrative costs, the launching of pilot tests that will allow physicians to conduct business with insurers over the web, other pilot projects aimed at aggregating physician performance data, and another pilot program for health plans to "assess their health literacy across their organizations and to build targeted health literacy programs, and further empowering consumers through the use of personal health records."

The hospitals have outlined a short term list of promises that has each of the eight bullet points begin with the word "promote."

Their longer-term to-do list uses the word "promote" in two of the six bullet points and uses the term "focus on" in two others. The remaining two bullet points talk about "further implementation" and one is about "creating a more efficient and transparent purchasing environment"--all pretty nebulous.

The AMA offers a list of programs already underway as does PhRMA. For example, the AMA says that, "Studies project large potential savings from adhering to evidence based guidelines for coronary artery disease." But there is nothing in their section that details any mandatory changes in the way things work now.

AdvaMed's list is equally vague and focused on existing programs. AdvaMed also talks about launching "an intensive education and awareness program to encourage our member companies to accelerate and intensify their risk management and human factors programs in product design." OK.

To me the common thread though each of the 28 pages is pretty clear--"We are on track to make America's health care system more efficient and better in quality. Leave us alone. And, if you'd like to send us another $100 billion a year without a lot of strings attached that would be fine too."

In the end, they have not once offered to put their money where their mouths are!

If you accept the stakeholders arguments what you do is leave the system to continue on its current path and assume the $2 trillion in savings will be there in ten years.

So, let's have a sort of "Where's Waldo" health care policy game. You can access the 28-page report here.

Can anyone find anything in this report that is "scoreable"--that is one can reasonably conclude there will be measurable and verifiable savings beyond where the system is already headed--which is 22% of GDP by 2018?

Where in any one of the 28 pages are any of them willing to take the risk their projections will be right?

And this kind of stuff gets you a meeting with the President?

Update: Here's Chuck Grassley's press release and a little Iowa common sense:
Sen. Chuck Grassley, ranking member of the Committee on Finance, today made the following comment on the health industry’s proposals to help save $2 trillion in health care costs.

“I’m skeptical that these proposals will add up to anywhere near $2 trillion. In the legislative process, proposals rise or fall based on what CBO says about them, and the same will be true here.”


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