Bredesen prescribes 'economic tension' for nat'l healthcare reform

At major Democratic gathering, Governor calls for action and HCA exec wants to send archaic practices to 'dustbin of history'

Email | Print By Milt Capps

Gov. Phil Bredesen

Although his party's presidential aspirants failed to attend, when Governor Phil Bredesen addressed the Democratic Leadership Council yesterday at Opryland Hotel he wielded a message that Democrats seem certain to use in the 2008 presidential campaign:

Bredesen said that with U.S. healthcare spending now 16.5 percent of the nation's economic output — and quickly "headed North" to perhaps 20 percent of GDP — our healthcare system is "unsustainable," as it currently operates.

Bredesen further argued that given that 96 percent of voting Americans have health insurance, but worry feverishly about paying for it, Democrats must understand that voters are "looking for relief in their health-insurance premiums."

He made clear Democrats and Americans, generally, must address the immense pressures upon those who are insured, even while tackling the needs of kids and adults who have no insurance coverage.

Bredesen's strategy for providing relief from insurance costs hinges on increasing the "economic tension" in relationships among all parties, partly by tieing reimbursements for hospitals and physicians ever-more closely to the quality of treatment outcomes. "Everybody," he said, "oughta have a little skin in the game."

Bredesen said his years as a healthcare-industry executive before becoming governor had convinced him that achieving affordable healthcare for all Americans faces one immutable reality: "Changing physicians' behavior is not possible, basically," he said, with only a hint of wry humor.

Particularly when it comes to getting physicians to adopt long-championed, but little used electronic health records for patients, government must "structure something where [physicians] almost have not choice" but to participate.

To push EHR adoption, he said, government might allow better reimbursement for physicians who employ EHRs for better treatment outcomes, or provide physicians who use EHRs more affordable malpractice insurance.

Nationwide use of EHRs is a key element in Bredesen's healthcare vision.  By making vital patients' medical histories available at every point in the healthcare system, he believes patient safety and wellness will improve, errors will be less frequent, insistence on wasteful procedures will drop dramatically and insurance will become more affordable.

HCA Chief Medical Officer Jonathan Perlin attended yesterday and seconded Bredesen's remarks, saying the emphasis on "quality really is the best business case" for providers, as well as for payers.

Among other evidence, Perlin said that "every fifth lab test in the United States is essentially repeated needlessly," because needed patient data was not available. It's time, said Perlin, "to relegate the ubiquitous filling-out of the clipboard to the dustbin of history," and replace that overly redundant, error-prone system with EHRs.

Yesterday, Bredesen repeated his charge, reported earlier by NashvillePost.com, that the Bush Administration's current strategy for advocating increased use of EHRs has become morbidly complicated, and the federal government must move quickly to impose technical standards for new healthcare information technologies.