Christopher Delporte, Group Editor07.27.07
Universal coverage and healthcare reform—they certainly aren’t new topics. And, without question, they remain political hot potatoes. Most people agree that overhaul is needed, but actually implementing real change is a different story. Political viewpoints vary—even within parties—and many on Capitol Hill consider it the “third rail” of politics, threatening to burn anyone who dares touch it.
Until recently, the medical device industry—though not without well-formed and informed opinions on the subject—has stayed clear of this hot-button issue. That has started to change. In June, the Advanced Medical Technology Association (AdvaMed) unveiled a plan it claimed would provide every American “the opportunity—and responsibility—to purchase affordable” coverage through the existing insurance market. AdvaMed said the plan is designed to provide a broadly supported, nonpartisan approach to improving healthcare.
“Our plan shows you can finance expanded coverage without rationing care or stifling innovation,” said Stephen Ubl, president and CEO of AdvaMed.
Within the proposal are mechanisms for public reporting of provider and health plan performance; financial incentives for physicians and health plans to deliver quality, efficient care—with special emphasis on chronic disease; support for expansion of information technology; and methods to evaluate technology’s impact on healthcare savings. The proposal also establishes a $10 billion fund for health promotion and disease prevention.
According to AdvaMed, the estimated additional annual cost of universal coverage is $167 billion. When cost savings are taken into account, the plan as a whole would save $226 billion in national spending and $105 billion in federal spending.
To ensure affordability, AdvaMed said premiums would be capped at a “reasonable percentage” of income that would be lowest for low-income individuals and families and then would rise as income rises. Any differences between the cost of coverage and an individual’s obligation to pay would be made up by subsidies in the form of refundable tax credits. Medicaid would remain an option for low-income and disabled populations, and the disabled not eligible for Medicaid would have the opportunity to buy wraparound Medicaid or equivalent coverage to meet their special needs. States would be responsible for structuring the private insurance market to ensure that individuals have a choice of coverage meeting national standards and encouraged to establish mechanisms to help small business offering coverage to provide a choice of options to their employees, the group said.
Only time (and protracted debate, of course) will tell if this plan—along with numerous other proposals from healthcare stakeholders—passes muster, but the attempt is a solid step in the right direction. The device industry is not a sidelines player and it should be able to influence broader healthcare policy than just FDA oversight and CMS coverage. Not only can tremendous patient benefits be derived from the cutting-edge technology device makers have to offer, but significant improvements in outcomes and cost savings can result as well. And with 50 million uninsured Americans (as of 2005), it’s abundantly clear that real solutions are needed sooner rather than later.