May 2008
A Nation at Risk

HMT From the Editor

By Michael McBride

With the recent opening of the "Hospital Compare" Web site (, the Centers for Medicare & Medicaid Services (CMS) and the U.S. Department of Health and Human Services (HHS) may be leading the race to transparency in healthcare and, consequently, to consumerism.

The site's tiny font makes it a challenge to read and it is somewhat non-intuitive to navigate (typical of many government Web sites), nevertheless, it contains a plethora of information and tools for comparing hospital quality of care and results.

For example, I learned that my own hospital compared favorably to the rest of the nation when it comes to providing discharge instructions following a heart attack (69 percent versus 66 percent nationwide). However, when compared to two other local hospitals it did not fair as well (69 percent versus 98 percent for the other two). This is the type of information savvy healthcare consumers want and need. We choose homebuilders this way, why not caregivers?

I could also compare the average Medicare payment for heart attacks (with and without complications) in my area versus the national average. I'm not sure how a consumer could use this information, but it's information, nonetheless.

It seems likely that true change in healthcare will be driven by health plans, and since Medicare accounts for about 40 percent of all claims (a number that will only increase), it makes sense that CMS/HHS would accomplish this now. Because, "As goes Medicare, so goes the nation" and, as we all should be aware by now, Medicare is in trouble.

According to the latest annual report from the program's trustees, Medicare will be broke by 2019 - if something drastic isn't done to save it. However, the point of no return may be reached as early as next year when, according to the report, Medicare's costs will exceed the tax revenues that pay for it, just in time for 78 million boomers to start receiving their benefits. It seems impossible that such dire predictions would be ignored - but they are.

The trustees have made these predictions for quite some time, but Congress is not sufficiently incentivized to fix the problem. In a recent news conference, Treasury Secretary Henry Paulson warned that if no change is made, "rising costs" will "consume nearly all projected federal revenues and threaten America's future prosperity." We're talking about our children and grandchildren's futures, but the mainstream media seems uninterested and these statements received little coverage.

The elderly comprise the fastest growing population in America; however, the number of practices accepting new Medicare patients is decreasing because Medicare reimbursements are diminishing, requiring doctors to work harder and harder to earn less and less. If Congress doesn't wake up and focus its attention on keeping Medicare solvent, this country is heading for a catastrophic financial event from which no amount of transparency or consumerism in healthcare will save us.

We teach our children not to leave important tasks to the last minute, but Congress seems determined to play political dodge ball with one of the most important tasks this nation has ever faced.

Copyright 2008
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