EY Partner Addresses Health Care Reform

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Dee Balle, Jr., Ernst & Young partner in the health care arena, spoke on RadioWallStreet on the issue of how the November election will affect sectors of the health care industry.

In a recent voter survey by The Washington Post, 44% of respondents ranked health care as a concern above education, crime, and economy, and 53% indicated they are dissatisfied with the current U.S. health care system.

The two presidential platforms are fairly close in their response to health care issues, however some people question whether either party is adequately addressing the issues.

Balle listed the four major health care issues covered by the party platforms as:
1. Expanding health care coverage to encompass more of the 44 million Americans that don't have acces to coverage.
2. Improving patient rights.
3. Addressing the high cost of prescription drugs, which has been going up about 15% per year. Seniors are especially impacted by this rise in cost.
4. Maintaining solvency of the Medicare trust fund.

Balle predicts that the next President and Congress will have to address at least these eight health care issues within the next 18 months:

1. Medicare reform - prescription drug benefits, and enhancement of medicare+choice program
2. Quality of care - there has been a high number of medical errors in US hospitals; additional quality requirements which will drive up costs for hospitals
3. Privacy of medical records - the feeling is that there needs to be more privacy to protect patients
4. Outpatient reimbursement under Medicare - this program was implemented August 1 and will be monitored
5. Access to care - the number of uninsured is up 6 million from 1992; tax incentives for purchasing health insurance will be considered as well as expanding access to Medical Savings Accounts
6. Patient rights - patients can't sue health plan for denials of coverage that are based on medical judgement; patient rights advocates are pushing Congress to do something to protect patients
7. Fraud & abuse issues - public percenption is that fraud & abuse is rampant
8. Effect of Balanced Budget Act of 1997 - the act was enacted to respond to double digit annual growth of Medicare but it had a significant negative impact on the financial health of hospitals and field nursing facilities. A new act enacted in 1999 is trying to put more reimbursement back into Medicare but hasn't had much impact.

The entire 30-minute audio broadcast is available on line.

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