Medical center team takes on health care reform

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Keith Mueller, Ph.D., makes a point during a health care reform discussion for media at the medical center last week as UNMC Physicians CEO Cory Shaw looks on. (Photo by Andrew E. Nelson, UNMC public relations)
As Americans buzz about health care reform, the complexities of health care reform remain difficult for most people to grasp. The topic seems to have more tentacles than an octopus.

That's where UNMC comes in. With a bevy of experts in all aspects of health reform, UNMC wants to be seen by Nebraskans as a resource for the state and the community.

Last week, UNMC took its first steps to provide information in the health reform arena when it briefed members of the news media and launched a new Web site on the subject.

"As the state's only public academic medical center, we feel an obligation to take the lead when an issue like this arises," said Bob Bartee, vice chancellor for external affairs. "Health care reform is going to have a huge impact on our society. We want to make sure that the medical center is helpful in explaining that impact."

Expert comments

Below are some comments from medical center personnel who took part in last week's health reform briefing, including two sound clips.

"What we're facing down the road is this perfect storm ... the average person over age 65 uses four times as much health care (than people under age 65)." -- Glenn Fosdick, president and CEO of The Nebraska Medical Center, on how the surge of baby boomers nearing retirement will impact health care

"The reimbursement system rewards physicians for the volume of care rather than the quality of care or long-term outcomes ... the more you keep people healthy, the less money the doctor makes. (On the other hand) the person reading CT scans gets paid for every scan they read." -- Tom Tape, M.D., section chief of general internal medicine at UNMC, on the shortcomings in our current reimbursement system

"When someone undergoes an endoscopy procedure today, they will likely receive four separate bills. One from the GI physician, one from the anesthesiologist, one from the pathologist, and one from the hospital. (With health reform, bundling will occur.) Under bundling, just one fee will be paid ... there's some merit for the bundling model." -- UNMC Physicians CEO Cory Shaw on how reimbursement could change

"We're increasing the demand for primary care at a time when what's called the match rate of students going into primary care residency is dropping. So we've got two curves going away from each other that we need to get converged in order to meet what the anticipated demand would be." -- Keith Mueller, Ph.D., interim dean of the College of Public Health, on how health reform will require more primary care physicians at a time when less medical students are going into primary care

"(With health reform, it will be vital) to educate the public on lifestyle and prevention. I'm worried (that health reform) could just swamp the primary care providers." -- John Benson, M.D., briefing moderator, on the huge demand health reform will place on primary care providers

"Medicare does not pay its fair share. Last year on a national basis, Medicare paid about 6.9 percent below what it costs hospitals to provide that care ... that gap is made up for by the amount that we receive from commercial insurance." -- Fosdick on how Medicare patients actually cost hospitals money

"The health reform debate won't end in August (when Congress convenes). The House and Senate will continue to work toward consolidating the different versions to come up with one final bill." -- UNMC Government Relations Director Mark Bowen on the bill timeline in Congress

Dr. Mueller comments on "universal coverage."

Fosdick comments on large employers and health coverage.

A committee representing many different areas on campus has come together to analyze many of the major proposals surrounding the health reform issue. The group primarily includes representatives from UNMC, The Nebraska Medical Center and UNMC Physicians.

Leading up to last week's media briefing, three white papers were developed by the committee and placed on the Web site. In addition, the Web site provides the latest information on the three health care plans that have emerged from congressional committees.

The white papers deal with universal coverage, workforce issues and payment/reimbursement. It's likely that more white papers will be developed by the group in the months ahead, said John Benson, M.D., professor of internal medicine and the moderator for the media briefing.

The three white paper topics were the basis of the discussion at the media briefing, and a fourth topic -- the impact of health reform on employers -- was added to the slate.

Besides Dr. Benson, other presenters at the media briefing included:

  • Mark Bowen, director of government relations for UNMC;
  • Glenn Fosdick, president and CEO, The Nebraska Medical Center;
  • Keith Mueller, Ph.D., interim dean, UNMC College of Public Health;
  • Cory Shaw, CEO, UNMC Physicians; and
  • Tom Tape, M.D., section chief, UNMC Department of Internal Medicine.

Six members of the news media attended the briefing. They included two health reporters and an editorial writer for the Omaha World-Herald, a reporter for the Lincoln Journal Star, and news directors for KETV (Ch. 7) and KPTM (Ch. 42).

The 90-minute briefing was filled with lively discussion and lots of questions from the media.

A sampling of some of the commentary can be read on the right.

The briefing was well received by the media. Indicative of this was an e-mail comment afterwards by Joe Radske, news director for KPTM.

"Thank you so much for holding the event on health care reform," Radske said. "It was excellent. I've already prepared a document for all my staff to read so they are better informed. There were multiple stories generated by the discussion."

The Health Reform Committee is tentatively planning two more events in August - a forum for employees and a conference open to the public. UNMC Today will provide all the details as these events are finalized.

Members of the medical center health care review group are:

  • John Gollan, M.D., Ph.D., dean of the College of Medicine
  • Bob Bartee, vice chancellor of external affairs
  • Pam Bataillion, associate professor and assistant dean for administration, College of Nursing;
  • Bob Bell, vice president for business and community development, UNeMed
  • Gerald Moore, M.D., professor of rheumatology, and senior associate dean for academic affairs
  • James Gigantelli, M.D., professor of ophthalmology and visual sciences, assistant dean of government relations
  • John Benson, M.D., professor of internal medicine
  • Kim McFarland, D.D.S., assistant professor, oral biology, College of Dentistry;
  • Keith Mueller, Ph.D., interim dean of the College of Public Health and health policy expert
  • Michael Sitorius, M.D., chairman of the Department of Family Medicine
  • Robert Wigton, M.D., associate dean for graduate medical education
  • Thomas Tape, M.D., section chief, Department of Internal Medicine
  • Mark Bowen, director of government relations
  • Barbara Schaefer, senior vice president, human resources, Union Pacific Railroad
  • Cory Shaw, CEO, UNMC Physicians
  • Bill Dinsmoor, chief financial officer at The Nebraska Medical Center
  • Harris Frankel, M.D., a private practice neurologist; and
  • Tom O'Connor, senior associate director, UNMC public relations.