Senate Budget Committee Chairman Kent Conrad (D-N.D.) said it will take more than what's in the stimulus package to reform U.S. healthcare.
"The administration has made very clear that they want to tackle this problem," Conrad said at a Tuesday Senate Budget Committee Hearing. "In fact, the economic recovery bill includes an important down payment on healthcare reform, with investments in health information technology, comparative effectiveness research and prevention and wellness efforts. But we all know it is going to take much more. There are more steps that must be taken to truly bend the cost curves of healthcare."
Conrad and the committee reviewed a December Congressional Budget Office report that outlines a number of payment reforms that could slow the spending growth in Medicare and other federal health programs. They include bundling payments for hospital and post-acute care; incentivizing physicians, hospitals and other providers to better collaborate; using bonuses and penalties in Medicare to promote the use of health information technology; and setting payment benchmarks for Medicare Advantage plans equal to traditional Medicare.
"It is important to remember that making these reforms does not mean lowering the quality of healthcare," Conrad said. "In fact, research suggests that some areas of the country that spend less on healthcare actually provide better healthcare."
According to the CBO report, healthcare spending will reach 37 percent of the GDP by 2050 if America stays on the current trend.
Key factors affecting healthcare spending include limited understanding of best practices, lack of care coordination and advances in medical technology, including drugs and medical devices, the report said.
Douglas W. Elmendorf, director of the Congressional Budget Office, said expanding health insurance and making the healthcare system more efficient are "complex endeavors in their own right, and interactions and trade-offs between them may arise."
Without changes in policy, he warned, a substantial and growing number of people under age 65 will lack health insurance.
The CBO estimates that the average number of non-elderly people who are uninsured will rise from at least 45 million in 2009 to about 54 million in 2019.
According to Elmendorf, the United States could achieve near-universal health insurance coverage by pooling risks, subsidizing health insurance and mandating or facilitating health insurance enrollment.
"An enforceable mandate would generally have a greater effect on coverage rates, but without meaningful subsidies it could impose a substantial burden on many people given the cost of health insurance relative to the financial means of most uninsured individuals," Elmendorf said.
