While President Barack Obama clearly wants a completed health care reform package on his desk sooner rather than later, Wisconsin Congressman Ron Kind says the issue deserves a more deliberate pace. "This is very complicated, it is very important, and there are a lot of different moving parts to it, and members want an opportunity to look at it, scrutinize it, ask questions," says the La Crosse Democrat.
Kind says House Democrats spent seven hours on Monday, going over existing provisions of the measure line by line. "I think the American people would like a little bit more time to digest what reform we're proposing out here," Kind says. "If it's going to happen – and I think it will – it's going to happen in the fall, with a little bit more time, and a little bit more work invested."
As for what a final reform bill will look like, Kind says it will be neither the socialized medicine claimed by conservatives or the cash cow for insurance companies feared by progressives. "Right now it's the extremes that are really out there with their talking points, trying to scuttle the bill," says Kind. The reform, he says, will be a compromise that builds on the existing health care system. Kind says there are really two debates going on Washington right now: whether to move ahead with reform, or do nothing. "We already know what the status quo is going to bring," he says. "It's going to bring an additional 14,000 Americans, every single day, losing their health care coverage. Double-digit premium increases for as far as he eye can see, and an exploding hole in our budgets at the federal, state and local levels."
Kind says he wants any reform to include a "value index" in the Medicare Part B reimbursement equation, because the current health care delivery system includes a lot of inefficiencies. "There's a reason why America's spending two to three times more per capita on health care . . . than any other nation in the world, and yet we're ranked 37th on health care outcomes," says Kind. "It's because we're spending a lot of money on things that don't work."
Kind says the "value index" would measure quality and efficiency of care. He says there are benchmarks of high value care right here in Wisconsin. "We have providers, models of care, that show how it's done," says Kind. "High quality results, lower costs. It's the Mayo Clinic System, it's Gunderson , Marshfield . And it's in other areas of the country, too."
"We've got providers in Wisconsin who are practicing value medicine, not volume medicine," says Kind. "And the dollars are really flowing to the volume of care that's given. As long as our providers are focused on the patient, practicing value, they're not going to be paid as much."
Kind says reform must also address geographic disparities in Medicare payments, which has been a recurring problem for health care providers in Wisconsin, particularly for rural hospitals. "If we don't do this, our providers in our area, from Mayo to Gunderson to Marshfield and across the state, tell me that they're going to be forced to practice volume medicine, to make more money. They don't want to do that."