Health Policy Forum, Friday Nov. 14, 2003.........
Southern Illinois University - Edwardsville

A Call to Action: Quality Healthcare for All

The annual Signature Healthcare Foundation Health Policy Forum was held on the campus of Southern Illinois University, Edwardsville, in November, 2003. The event was co-sponsored by SIUE and the SIUE School of Nursing and was attended by a standing room only crowd.

Many in healthcare would profess that the United States healthcare system is headed for crisis; recent media coverage would indicate that many employers, government leaders and private citizens agree. In such an environment, the Health Policy Forum is an important opportunity to come together, to learn, to discuss, and to explore new ideas so that new solutions can be formulated.

• To educate the medical community, general public, governmental officials and employers about current major issues and trends in health care
• To raise awareness about the need for maximizing efficient business practices relative to health care
• To showcase methods to improve efficient business practices
• To demonstrate and discuss the importance of physician leadership in all components of health care delivery

Former Illinois Senator Paul Simon welcomed participants to this first annual event and gave a moving introduction about the importance of healthcare to all Americans.

Dr. Stephanie Woolhandler provided a stimulating keynote address. Dr. Woolhandler has both an MD and a Masters in Public Health. She practices primary care internal medicine at the Cambridge Hospital and teaches at Harvard Medical School where she is an associate professor of Medicine. In 1986, she co-founded Physicians for a National Health Program, which advocates a single-payer system of national health insurance for the United States.

Dr. Woolhandler has conducted a number of studies of healthcare financing and administrative costs in medicine, including a recent report highlighting the large differences in administrative costs between the United States and Canadian healthcare systems.

Dr. Woolhandler presented information on the per capita costs of hospital billing and administration in the United States and Canada. As of 2000, the United States spent $372 per capita and Canada $68 per capita. Physicians’ billing and office expenses share the same comparisons. As of 2000, United States physicians’ offices spent $430 per capita for billing and office expenses, while those practicing in Canada spent only $102 per capita. There are clearly many other price differences which cause health care costs as a percent of GNP to be so much higher in the United States than Canada; however, the administrative differences are particularly disturbing in that they do not directly relate to the provision of care for patients.

"We need to be informed - not only participators in this movement but leaders for change." Dr. James Herndon

The forum also featured a luncheon address by Dr. James H. Hernon. Dr. Herndon is on the faculty of Harvard Medical School and President of the American Academy of Orthopaedic Surgeons. Dr. Herndon’s address focused on the issue of safety. He gave this reason for his focus: “I believe that patient safety is the most crucial issue because it appears to be the problem that we are least willing to recognize and address and it most seriously threatens our autonomy as professionals”. Dr. Herndon reviewed his belief that changes in regards to patient safety and medical error are going to come regardless of actions of healthcare providers due to pressure from patients, from businesses such as the Leapfrog Group, and from the government. “Knowing that these pressures for change are occurring should be enough of a stimulus for us, the physician providers of patient care, to begin to change our thinking. We need to be informed – not only participators in this movement but leaders for change. Not only is it the right thing to do, it is essential. If we do not take the lead, then our professional rights and obligations will be taken away from us”. His address included specific suggestions for actions by physicians including the acceptance of evidence-based principles of standardization, adopting core safety practices and focus on system issues.

As of 2000, the United States spent $372 per capita and Canada $68 per capita on hospital billing and administration.

The Forum also included a panel on government relations and several workshop sessions. Workshop sessions included: Judith Hibbard, PhD, Professor in the Planning, Public Policy and Management Department at the University of Oregon who conducted a session focused on making health care performance reports more effective. Dr. Hibbard presented results from a Wisconsin study indicating that making public performance reports did influence consumer’s views and behaviors and that the reports increased hospital motivation to improve.

Sandra Foote, Director of the Health Insurance Reform Project at The George Washington University discussed plans in Congress and in the Centers for Medicare and Medicaid Services to adopt population-based disease management programs under fee-for-service Medicare.

Dr. William C. Schroer, Orthopedic Surgeon, Signature Health Services, Inc. reviewed the potential clinical advance of minimally invasive total knee surgery and the financial incentives and disincentives of this type of innovation.

R. Jeffery Davis, Vice President, Aon Consulting, Inc. discussed cost control alternatives to managed healthcare.

The 2004 Health Policy Forum will be held on Friday, October 22 nd at the Frontenac Hilton.