state of health care

President Bush summarized his healthcare proposals in this passage of the 2005 State of the

To make our economy stronger and more productive, we must make health care more affordable, and give families greater access to good coverage and more control over their health decisions. I ask Congress to move forward on a comprehensive health care agenda with tax credits to help low-income workers buy insurance, a community health center in every poor county, improved information technology to prevent medical error and needless costs, association health plans for small businesses and their employees, expanded health savings accounts and medical liability reform that will reduce health care costs and make sure patients have the doctors and care they need.

Clearly, healthcare financial professionals are concerned about the challenges of providing coverage for the uninsured, implementing effective IT solutions, and ever-increasing medical liability costs. But are the solutions the president proposes realistic, especially given the current divisive political environment?

Take the challenge of providing coverage for the uninsured. Community health centers may be a good primary care solution for the uninsured poor. They do not, however, address more serious medical needs such as complex diagnostics or hospital inpatient and outpatient services. And will tax credits encourage uninsured low-income persons to purchase insurance? Given their limited disposable income, probably not.

Association health plans and health savings accounts may help businesses better afford to provide coverage to employees; however, these plans often require large deductibles, further aggravating the collection problems and costs of healthcare providers. While these solutions will help, the problem still requires comprehensive, not piecemeal, approaches.

Stating that improved IT will help prevent medical errors and needless cost is important. The president, however, did not offer any plan to assist in the acquisition and implementation of these systems. HFMA's series, Financing the Future documented concerns about access to financial capital to pay for IT investments.

I applaud the president's continued effort to seek national medical liability reforms. Bills introduced last year moved further toward a solution than ever before. Whether Congress can muster the votes necessary to enact effective reforms, however, is a real question. Most experts believe that more success will be found at the state level.

Health care is one of the largest segments of the U.S. economy. It is unfortunate that the president's first State of the Union for his second term contained such limited references to the problems and needed solutions to the challenges he mentioned. And given the ever-growing federal budget deficit, the war on terrorism and in Iraq, limited federal tax revenues, and other challenges, it is doubtful that any new dollars will flow into needed solutions.