Neera Tanden of the Center for American Progress (left) and Thomas Miller of the American Enterprise Institute debate at the 13th annual World Health Care Congress.
For nearly an hour Sunday afternoon, Beltway policy wonks spent the opening session of the 13th annual World Health Care Congress talking about health insurance and healthcare costs and presidential politics.
This being Washington, there had to be a debate between someone on the left, namely Neera Tanden of the Center for American Progress, and someone on the right, namely Thomas Miller of the American Enterprise Institute. They tossed out the usual talking points, but avoided the elephant in the room — real healthcare reform.
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Then, during the audience Q&A, a certain MedCity News reporter stood up and called Tanden on one of her earlier statements: that the U.S. healthcare sector needed to “maintain quality” while dealing with expansion of coverage to millions of previously uninsured people.
The problem is, quality of American healthcare isn’t exactly something to be proud of.
A group called Patient Safety America has said that medical error is the third-leading cause of death in the United States, killing as many as 440,000 people a year. Even supposedly prestigious institutions have unexpectedly high error rates, and providers routinely try to hide their mistakes.
Session moderator, USA Today reporter Jayne O’Donnell, who has been on the healthcare beat for just a couple of years, said she was “shocked” when she heard the Patient Safety America numbers a few months ago.
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In attempting to answer the question, Tanden mentioned the fundamental issue of trying to communicate complex issues in a society that loves sound bites. “It’s hard to talk about quality and outcomes,” Tanden said.
Tanden noted that there is a “deep and fundamental skepticism” about government regulating the practice of medicine. She recalled the debate about Medicare paying physicians for end-of-life counseling and of comparative-effectiveness research. Both ideas are in the Affordable Care Act, though the public didn’t hear much about either except under the guise of the headline-friendly “death panels” smear.
Miller, no fan of the ACA, mostly agreed that it was easier to discuss costs and coverage than quality and safety. He suggested that the government needed to “regulate less and inform more” — and at one point mildly praised the Obama administration for at least attempting to advance price transparency. (That was before the certain MedCity News correspondent steered the conversation toward safety.)
In talking about quality of care, Miller briefly referred to Meaningful Use as “meaningless” these days, and Tanden concurred. Both also agreed that the ACA is not going away, despite the promises of Republican presidential candidates.
See, folks, there is common ground to be found out there. You just have to be willing to look.
