Tuesday's Prescription for Reform Health Care Summit at the University of Minnesota already had a lineup of health policy heavyweights. But the event's host, Sen. Amy Klobuchar, D-Minn., scored a last-minute coup by helping persuade Neera Tanden, a top domestic policy adviser to President-elect Barack Obama, to attend.
Tanden is a former policy adviser to Hillary Clinton, one of the main architects of the sweeping but doomed 1993 plan to overhaul American health care. Tanden's new post under a new president signals Obama's intent to follow up on campaign promises to fix a system that is the world's most expensive, with a growing number of Americans unable to afford care. Come January, as the new Congress convenes and Obama is sworn in, Tanden will be one of the key voices shaping the debate over this ambitious, much-needed reform.
And that's exactly why Tanden's visit to Minnesota was well-timed. This is a state where health care is done right. Its providers have long been pioneers in delivering high-quality care -- maximizing the best outcomes and patient satisfaction while minimizing costs and errors. The care you get at your local clinic and hospital, the insurance plan you consider every year during open enrollment, very likely involves one of the state's world-class medical organizations, one whose everyday practices may be a model for the rest of the nation.
The state's health care community and its policymakers are well aware of the need for reform. For some time, the Mayo Clinic's Dr. Denis Cortese, HealthPartners' Dr. George Isham, Klobuchar and former Sen. Dave Durenberger have been some of the most prominent national voices calling for a Medicare payment reimbursement. That's solid advice that Tanden should heed as the administration considers its options.
This sprawling, $400-billion-a-year health care program provides care to about 37 million seniors and about 7 million adults with permanent disabilities. It's a good and much-needed program. But its costs are simply unsustainable. Right now, it's about 14 percent of the federal budget. Without changes, it will swallow an ever-increasing share of taxpayer dollars, diverting resources from education, infrastructure and other needed programs.
Minnesota's health industry is acutely aware of this problem because one of the fundamental problems of Medicare is that it rewards providers who do the most procedures, not those who have the healthiest patients. According to Klobuchar, a Medicare enrollee in Miami costs twice as much on average each year as a Minneapolis senior. In other words, good providers like those in Minnesota earn less while providing better care.
The problem has been a thorn in the side to good providers, and solutions have long been debated and discussed. Tanden and crew won't need to reinvent the wheel. Instead, they could implement changes to the Medicare reimbursement system on which there's already consensus in the industry. These include bundling payment for a condition such as diabetes vs. handling payment for each service. Another change would provide incentives for quality care and use of accepted best practice guidelines in treatment.
As a health care expert, Tanden is likely well aware of these potential solutions and the need for them. Her willingness to visit Minnesota at this critical time indicates that she respects the pioneering work already done here and that the new administration is listening to the right people as historic changes are under consideration.