IOM Report Says U.S. Health System in ‘Crisis,’ Suggests Bush Administration Test Possible Reform Strategies
The U.S. health care system is in "crisis," and the Bush administration should "immediately test possible solutions" by implementing pilot projects in several states, a panel of health care experts said in a Institute of Medicine report released today, the New York Times reports. The 16-member panel, which includes doctors, lawyers, a nurse and several educators, wrote in the report, "The American health care system is confronting a crisis. The health care delivery system is incapable of meeting the present, let alone the future, needs of the American public." Problems cited by the panel include that the cost of private health insurance is rising by more than 12% annually; health care consumers are paying more out of pocket for fewer benefits; more than 14% of Americans lack health coverage; states are cutting eligibility and benefits under Medicaid and other public health programs; and "tens of thousands" of people are dying each year because of medical errors (Pear, New York Times, 11/20). Today's report follows a separate report released last week by the IOM that said the nation's public health system needs a "major" overhaul to enable states to effectively deal with mounting threats such as infections, preventable diseases and bioterrorism (California Healthline, 11/12).
The report, "Fostering Rapid Advances in Health Care: Learning from System Demonstrations," recommends several pilot projects to address the "critical aspects of a reform strategy" (IOM, "Fostering Rapid Advances in Health Care: Learning from System Demonstrations," Institute of Medicine report, November 2002). For instance, it suggests that three to five states ensure affordable health coverage "for all citizens and legal residents," either through tax credits or expansions of Medicaid and CHIP programs. The report also recommends that between four and five states test "alternatives to medical malpractice suits," by setting up a program under which patients who waive the right to a trial would receive "faster, fairer, surer compensation." Under the pilot project, states could cap awards for pain and suffering and other noneconomic damages, and the federal government could subsidize malpractice insurance for providers who "promptly compensate patients for 'avoidable injuries,'" the Times reports. The report also suggests other pilot projects, including boosting use of computers to create a "paperless health care system," implementing new medical technology at 40 community health centers nationwide and examining new ways to manage chronic illnesses. The report does not include estimates of how much each pilot project would cost. HHS Secretary Tommy Thompson next year could begin some of the pilot projects without obtaining congressional approval or funding while others would require approval, the Times reports (New York Times, 11/20). The complete report is available online. Note: You will need Adobe Acrobat Reader in order to view this report.This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.