New law has long way to go: Pollack
by David Burda
Though he praised passage of the landmark healthcare reform legislation, the American Hospital Association's point man in Washington said the new law has a long way to go to satisfy all the concerns of the nation's hospitals.
"Some say the bill doesn't go far enough in terms of delivery system reform. Others say it goes too far," said Richard Pollack, the AHA's executive vice president of advocacy and public policy. "I think there's a balance here that one could argue is appropriate."
Though he highlighted a number of shortcomings in the bill, Pollack said the AHA ultimately supported the measure for four important reasons:
- The bill extends insurance coverage to 32 million people.
- No one segment of the healthcare industry got everything it wanted.
- The bill includes long phase-in periods that Pollack said will give the AHA "numerous opportunities to improve the legislation over time."
- The alternative to reform was straight deficit reduction, or as Pollack described it, "All pain and no gain."
Among the measure's shortcomings, according to Pollack, is the fact that millions of people will still lack insurance coverage under the bill and that the bill failed to include "meaningful" liability reform. He also said the bill failed to expand Medicare graduate medical education slots to the extent sought by the AHA, and it failed to address end-of-life issues. But the biggest shortcoming of the bill is the fact that it passed in such a partisan way, Pollack said, unlike other pieces of major domestic legislation over the years.
"Can reform meet the test of time when done in such a partisan way?" Pollack said.
Pollack urged the healthcare executives in attendance to start shifting their mindset from passage to implementation. Rules and regulations will have to be written to guide how such things as insurance exchanges, value-based purchasing and price transparency will become operational in a reformed healthcare system.
The reform bill will be "fixed and refined for years to come," Pollack said. "Certainly we will have our own legislative fix-it list." Among the items on the AHA's punch list will be amending the financial penalties for hospital readmissions, said Pollack, adding, "That didn't come out the way we wanted."