The Future Of Health Care Ob-Gyns Get Lesson On What's Driving Reform

Main Category: Women's Health / Gynecology
Also Included In: Pregnancy / Obstetrics
Article Date: 06 May 2008 - 4:00 PDT

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Spiraling health care costs and the imperative to improve patient safety and quality performance represent the most important issues on the US health care agenda, according to Gail Wilensky, PhD, a leading health care economist, who delivered the Samuel A. Cosgrove Memorial Lecture, "The Future of Health Care," during the opening session of The American College of Obstetricians and Gynecologists' (ACOG) 56th Annual Clinical Meeting.

"Over the last 40 years, annual health care spending has been growing faster than inflation," said Dr. Wilensky, an economist and senior fellow at Project HOPE, a health education foundation that works to make health care available around the world. "This is simply not sustainable, and to me, is the No. 1 priority of health care reform.

"If we don't find a way to slow spending down-not reduce spending, but slow it down-this spending growth will put tremendous pressure on the federal budget and also on the rest of the economy," added Dr. Wilensky. "To make matters worse, health care spending exacerbates the already huge problem of access to health care for millions of Americans."

At Project HOPE, Dr. Wilensky analyzes and develops policies related to health care reform and ongoing changes in the health care environment. In the early 1990s, she directed the Medicare and Medicaid programs and served as deputy assistant to President George H.W. Bush for policy development, advising him on health and welfare issues. From 1997 to 2001, Dr. Wilensky chaired the Medicare Payment Advisory Commission, which advises Congress on Medicare issues.

The other reform initiatives Dr. Wilensky believes are necessary to improve the US health care system include addressing the serious quality problems in both patient safety and appropriateness of care. She acknowledged that the patient safety movement gathered momentum after the Institute of Medicine's report To Err is Human (published in 2000) indicated that, at best guess, about 100,000 people are dying every year from medical errors, but she asserted, "Not nearly enough has been done to address the issue of patient safety in the last five years."

One of the areas Dr. Wilensky has been working on is comparative clinical effectiveness-the rationale being that providers can be paid more per service if they reduce the volume and intensity of services that don't seem to be productive. She noted that in terms of quality performance, studies have indicated that patients receive on average about 55% of procedures and treatment that are clinically appropriate.

"ACOG has a long-standing commitment to improving quality and safety in women's health care," said ACOG President Kenneth L. Noller, MD, MS. "We strongly believe that quality assurance and patient safety programs are pivotal to advancing women's health. We will advocate for these important issues in any and all health care reform."

The American College of Obstetricians and Gynecologists is the national medical organization representing over 52,000 members who provide health care for women.

American College of Obstetricians and Gynecologists