HMO REFORM: Ellwood Says System Will Never Fix Itself
The man acknowledged as a founding "father of the HMO movement" and "the nation's most influential health policy guru" told a "startled" Harvard University conference audience Saturday that he was pessimistic that doctors and health plans alone could provide high-quality medical care. Dr. Paul Ellwood, whose Jackson Hole Group was responsible for many of the ideas behind the managed care revolution, said, "Uneven health care in the United States is a national disgrace. It's unacceptable, and it can't be allowed to continue. ... Ultimately this thing is going to require government intervention." Motivation to improve the quality of medical care "is not going to come from within" the health system, he said. Arguing in favor of government-mandated disclosure of health plan patient outcomes, Ellwood added that "market forces will never work to improve quality, nor will voluntary efforts by doctors and health plans," and predicted double-digit increases in health premiums will soon be back "with a vengeance." He concluded, "It doesn't make any difference how powerful you are or how much you know. Patients can get atrocious care and can do very little about it. I've increasingly felt that we've got to shift the power to the patient. ... I'm mad -- in part because I've learned that terrible care can happen to anyone" (Knox, Boston Globe, 5/2).
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