Congressional Republicans released a host of health reform solutions on June 1 designed to “harness technological innovations to improve Americans’ lives and save taxpayer dollars.”
The proposals by the Modernization Subcommittee of the Healthy Future Task Force include extending telehealth access after the COVID-19 public health emergency expires; eliminating waste, fraud, and abuse by rewarding states that crack down on improper payments; and expanding the use of technologies to improve patient well-being.
“Instead of a government-run, socialized system that would destroy medical innovation, we need to modernize and personalize health care in America to improve people’s lives and lower their costs,” said task force co-chairs Rep. Brett Guthrie (R-KY) and Rep. Vern Buchanan (R- FL) in a statement.
Reform Wish Lists
The Healthy Future Task Force was created by House Republican Leader Kevin McCarthy and is comprised of 17 Republican members of the U.S. House of Representatives, including several physicians.
In addition to modernization, there are groups on treatment, security, affordability, and the doctor/patient relationship also working on solutions.
The Treatment Subcommittee recommended removing barriers to access for innovative treatments, devices, and, diagnostics; lowering drug costs by passing H.R. 19, the Lower Costs, More Cures Act of 2021, introduced by Rep. Cathy McMorris Rodgers (R-WA); and the promotion of medicines manufactured in the United States, on April 1.
The Security Subcommittee’s solutions include ensuring the nation is better prepared for pandemics, holding China more accountable for its role in COVID-19, more oversight of research money going to adversaries, and requiring more transparency from federal health agencies, on May 18.
Among the solutions the Doctor-Patient Relationship Subcommittee is considering are removing the COVID-19 vaccine requirement for health care workers and easing the complexity of electronic health records so doctors spend more time with patients.
‘Be Bold’
The task force is punting on the most important reforms, says John Goodman, the president of the Goodman Center for Public Policy and co-publisher of Health Care News.
“It is time for Republicans to be bold,” said Goodman. “Rep. Pete Sessions’ bill is a great place to start.” (see related article, page 3)
Sessions’ (R-TX) Health Care Equality and Modernization Act of 2022, H.R. 7258, would repeal the remaining mandates in the Affordable Care Act and increase patient choice, says Goodman.
“Obamacare is unaffordable and deprives patients of getting access to the best care,” said Goodman. “That’s what Republicans should fix.”
Relax Privacy Rules
The Health Task Force should also address the government’s overregulation of health care technology, says Josh Umbehr, M.D., a Kansas family physician and founder of Atlas MD.
“In general, I think the main thing the government needs to do in terms of telemedicine is be very flexible with the rules,” said Umbehr. “It is ridiculous to have no care to ensure it’s secure care.”
Privacy rules under the 1996 Health Insurance Portability and Accountability Act (HIPPA) intended to protect patient confidentiality have made it difficult for providers to share information but were relaxed due to the COVID-19 pandemic, says Umbehr.
“COVID was pretty unique,” said Umbehr “The [government] did something pretty atypical and changed 20-plus years of bad HIPAA rules in a good way,” said Umbehr. “Too much security [under HIPAA] can make something so cumbersome it’s unusable.”
Physicians are required to implement electronic health records and websites, but those technologies conflict with HIPAA rules says Umbehr.
“[Patient] portals became so unusable with government requirements,” said Umbehr. “While they might meet requirements, they have nothing to do with consumer usability. When things are easier, patients are more likely to get good health care. Security is probably not as important as we talk about,”
The direct pay model in which consumers, not insurance companies, reimburse providers for care, would reduce costs, says Umbehr.
“The goal should be that most health care is too cheap to insure,” said Umbehr.
Missing: Physician Compensation
In its quest to improve health care, the task force is overlooking the key factor of compensating primary care physicians and nonsurgical specialists, says Rebekah Bernard, M.D., author of Patients at Risk.
“They are missing the number one issue—physician pay—which continues to be cut even while the cost of everything is going up,” said Bernard. “I would like to see a focus on immediate reforms and increases to physician payment, without budget neutrality. This must emphasize primary care and ‘cognitive,’ nonprocedural specialties.”
Ashley Bateman (bateman.ae@googlemail.com) writes from Virginia.
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