Health Care 2014 - The Politics And Ethics Of Health Care Reform

Overview: All major health policy initiatives that seek to redraw lines and reshape the system are going to be controversial; that is a given. However, recent efforts to address cost, coverage, and efficiency issues in the system have produced a firestorm of debate, political posturing, and questionable behavior. There have been threats, dire predictions of disaster, overblown expectations, dysfunctional web sites, quirky Supreme Court decisions, and other events that have turned the normally dry field of health policy into high drama.
Patients are turning to health care professionals to find out what is really going on, and many of those professionals are not always able to separate the wheat from the chaff. Among the key issues are:
Patient fears that Medicare will somehow be compromised or even eliminated
Massive variations among states regarding expansion of the Medicaid program
Insurer practices that appear to be seeking to continue the practice of discrimination against the sick - practices that in some cases have the support of state governors, who are refusing to enforce anti-discrimination provisions of the ACA
Concerns about the privacy of personal patient medical information, which has always been at risk, but is widely seen as being more vulnerable as system- and even community-wide health care data bases are developed and electronic medical records and e-prescribing become the order of the day
Issues of access to care, as fewer and fewer physicians accept Medicaid patients, physicians treating Medicare patients move to "concierge" practices, and physicians move from individual or small-group practices to large medical groups
The growing problem of overprescribing and misuse of opioids and other addictive drugs - will e-prescribing make it worse?
The battle for the "hearts and minds" of the public, which has involved both scare tactics and intentional misinformation
None of this is new; the battle 50 years ago over the creation of Medicare and Medicaid was one of the nastiest political fights in American history. When the war was finally over, the most powerful lobby in Washington, DC, had lost much of its clout, and a new era of government involvement in care of the aging had been ushered in. Could the current debate have similar far-reaching consequences?
This webinar will examine what has happened historically with tough health policy fights and their results, and will apply some of those lessons to the current situation. It will also provide objective information about some of the major contemporary battles, what the truths and falsehoods are, and what may happen with regard to them. It will also identify political and ethics issues that are part and parcel of the changing scene that have been largely overlooked - and that could play a major role in determining the success or failure of health care reform. These include ACA's failure to provide for the poorest of the poor, the gray area of coverage for undocumented immigrants, the coming fight over what constitutes optimal care for a given condition, changes in payment structure that will force providers to think in entirely new ways, and the failure of the ACA (or any other initiative, for that matter) to ensure that health care will be both accessible and affordable going forward.
Why should you attend: There has been enough inaccurate information spread about the major reform initiatives of the day - the Affordable Care Act (ACA), the HITECH Act, and state coverage innovations - to make the Brothers Grimm appear to have been telling the absolute truth. That has been one major dilemma in the debate over sweeping changes in the health care system that is being attempted by powers both public and private. But there have been other problems as well, and among them has been a passionate, but at the same time, dispiriting political fight over government's role in health care and the responsibility of the individual. Insurers have tried to get around the new rules; state governors have refused to participate in or enforce certain provisions of the Affordable Care Act; adoption of new approaches by providers, even when virtually mandated, has been spotty. The result is a landscape littered with uncertainty and inconsistency that has left the average health care professional confused and, in many cases, angry.
On top of those stresses have been thorny ethics problems that have dogged reform efforts from the beginning. A provision in the ACA that would have paid physicians $50 for discussing end-of-life issues with Medicare patients (which most physicians do, anyway) was condemned as an attempt to shorten the lives of those patients. A commission charged with finding ways to reduce inflation in the Medicare program was condemned as a "death panel." A $2 billion fund to improve public and preventive health activities was diverted by Congress to non-health care purposes.
Where does the truth lie? How can the politics of health get this ugly? What are the real political and ethical quandaries posed by health care reform, and how might they be addressed? Health care professionals need to know, not only in order to be in compliance with new laws and regulations, but also because they should be involved in addressing these thorny issues.
Areas Covered in the Session:
Previous major battles over health care system reform initiatives - what happened and why
The politics of reform - high stakes, key players
Unresolved political issues of recent reform initiatives
Unresolved ethics issues of recent reform initiatives
Improving both the environment and the quality of the debate
Who Will Benefit:
Health Care Professionals
Hospital and Health System Trustees
Executives, Clinician Leaders, and Department Heads
Employers and Employer Health Care Coalitions
Biomedical Ethicists and Consultants
News Media Representatives who cover the health care field
Community Health Care Advocates
Health Care Planners
Emily Friedman is an independent health policy and ethics analyst based in Chicago. She has been researching and writing and speaking about health policy since 1977. Among her areas of interest are future trends in health care; health care reform initiatives; “comparative effectiveness” and other quality improvement efforts; the social ethics of health care; the future of health care leadership; the ethics of health care leadership; health policy and how it works (or doesn’t); the impact of demographic change on health care; insurance and coverage issues; lessons from international health systems; and the relationship of the public and society with the health care system. She is an Adjunct Assistant Professor at the Boston University School of Public Health, where she has repeatedly been named one of the School’s best teachers; an honorary life member of both the American Hospital Association and the American Medical Association; and a prolific lecturer and writer.
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