ClarkeFrom President and CEO Richard L. Clarke, DHA, FHFMA

Health reform is all over our computer screens, TV sets, and discussions with colleagues and the community. The passion surrounding the debate is understandable. Health care is both very big and very personal--big enough to affect our ability to price goods and services competitively in the global marketplace and personal enough to touch each one of us as we try to manage our own health and pocketbooks. As healthcare professionals, of course, we have an additional stake in reform: We want to ensure we continue to have the resources necessary to improve the health of our communities.

Reform efforts are focused on improving access to healthcare coverage, reducing the growth in healthcare costs that impacts U.S. competitiveness, and improving health by enhancing prevention, primary care, and management of chronic conditions.

In the midst of the debate, I encourage all of us to reflect on these goals of reform and their importance to our society. We must relieve our economy of the burden created by the unsustainable growth in healthcare costs. Everyone deserves access to care coverage. And for both health and economic reasons, care should emphasize health promotion, coordination across settings, and outcomes that are consistent across regions and populations.

An overwhelming amount of data shows that our healthcare delivery and payment system is unsustainable. As financial leaders, we have to deal with this dysfunctional system. And for almost everyone--providers, patients, employers--it is very frustrating. Action is needed before the problems get worse.

We should be encouraged that--after decades of effort--there seems to be significant legislative energy focused on achieving these goals, as well as support from diverse stakeholders. While the current proposals before Congress are problematic, at least there is heightened debate and momentum for action.

Naturally, not everyone agrees on the tactics. Of particular concern to HFMA members and other providers is whether reform will result in arbitrary cuts to current payment rates without addressing the underlying issues that drive cost--namely the lack of coverage for far too many, conflicting payment incentives, and overpowering regulatory burdens. They worry that payment cuts will be used to pay for reform elements instead of thoughtful and appropriately timed changes in the payment system to get all components to operate within the goals of reform listed above.

There is considerable concern that any significant change in how revenue flows into and within the system must be accompanied by a carefully considered transition plan, and funding, that allows the system ample time to adjust to the changes.

Reform is too important not to get right, and the dimension of the task makes it complicated and often frustrating. Yet, it is my hope that, while we debate the path to reform, we keep in mind the overriding goals of reform and the benefit to our nation if we achieve those goals in a thoughtful, well planned way.

August 12, 2009

Publication Date: Wednesday, August 12, 2009