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Health care isn't good enough

Experts at Cleveland Clinic forum want lower costs, better quality, more coverage

By Tracy Wheeler
Beacon Journal medical writer

CLEVELAND: Health-care spending in America tops $2 trillion and accounts for 17 percent of the nation's gross domestic product.

Yet 47 million Americans are uninsured, 18,000 die every year because of a lack of health insurance, 98,000 die each year from avoidable medical errors, 103,000 die every year from infections they caught while in the hospital and half of all patients don't receive the recommended care that they should.

''For $2.4 trillion a year, we can do better,'' Henry Aaron, a senior fellow at the Brookings Institution and former health-care adviser to President Jimmy Carter, said Thursday at an ''Opportunity '08'' forum sponsored by Brookings and the Cleveland Clinic.

The theme of the forum was to reform health care by expanding health insurance coverage to more people, improving the quality of care and lowering costs.

It would be ''nice if we could do all three things at once,'' said Alice Rivlin, a Brookings fellow and former director of the Congressional Budget Office. Nice, and necessary.

''Without reducing costs, we won't be able to cover more people, which is what most people want,'' Rivlin said.

And, she said, reducing costs relies on improving quality of care, by reducing medical errors, avoiding wasteful, ineffective treatments, making proper use of technology and placing an emphasis on preventive medicine and disease management.

The federal government can set an example by continuing to use Medicare as a model for which treatments are effective, Rivlin said, while using a combination of market forces and regulatory authority to promote efficiency.

The Cleveland Clinic kicked off its discussion of national health policy this month when presumptive Republican presidential nominee John McCain rolled out his health-care proposal May 1. The Democratic nominees have also been invited, though they have not yet confirmed when or if they will participate in a similar session.

Though the ''Opportunity '08'' series carries the tag line, ''Independent Ideas For Our Next President,'' there was no discussion of the health-care plans of the 2008 presidential nominees.

Dr. Constance Magoulias, a family physician with MetroHealth Medical Center, told the panel during a question-and-answer session that she was disappointed that the idea of universal coverage received almost no attention during the forum.

''I don't understand why it's not even being mentioned,'' she said, because it seems to address all the issues presented Thursday — expanded coverage, reducing costs to businesses, reducing costs to consumers and reducing administrative overhead.

Aaron responded that insured Americans simply aren't ready to trade in their current health insurance for a government- sponsored plan. And Rivlin had said earlier that universal health care would present the same problems, simply in a different form.

Besides, Aaron said, real reform is going to have to come at the state level.

Ohio state Rep. Jim Raussen, R-Hamilton County, and Doug Anderson, the Ohio Department of Insurance's chief policy officer, said a state advisory panel has goals of reducing the number on uninsured Ohioans from 1.3 million to 500,000 by 2011; providing coverage to every child; helping small businesses provide coverage to their employees; and guaranteeing an affordable insurance market.

Tom Latkovic, a partner with the management consulting firm McKinsey & Co., said a focus on the health of the overall population, targeting obesity, smoking, lack of exercise, good nutrition, management of chronic diseases, and preventive medicine can reduce the state's overall health-care costs.

Such a focus would also help the statewide economy by giving Ohio a healthier work force and a magnet to attract talented workers from elsewhere.


Tracy Wheeler can be reached at 330-996-3721 or tawheeler@thebeaconjournal.com.

CLEVELAND: Health-care spending in America tops $2 trillion and accounts for 17 percent of the nation's gross domestic product.

Get the full article here.


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