Opinion Pieces Address Issues Related To Health Care Reform

Summaries of two recent opinion pieces about issues related to health care reform appear below.

• Joseph Dorsey/Donald Berwick, Boston Globe: "The closest you can come to heresy in today's health care policy debate is to suggest that managed care can help and that capitation is the best way to pay for it," Dorsey, former medical director at Harvard Pilgrim Health Care, and Berwick, president and CEO of the Institute for Healthcare Improvement, write in a Globe opinion piece. According to the authors -- who both practiced medicine within a managed care system under the Harvard Community Health Plan -- managed health care "was a great idea when it first emerged, before the term got hijacked by insurance companies that claimed to manage care but in many cases only managed money." They add that, in managed care, details "matter -- a strong focus on patient satisfaction, compensation and incentives, sound leadership, transparent and sophisticated measurement and information" -- and that, when "done right, managed care works." The authors conclude, "Maybe, properly defined and designed, these may not be dirty words after all" (Dorsey/Berwick, Boston Globe, 2/27).
  
  
• Ruth Marcus, Washington Post: "Away from the distorting glare of the campaign trail," a "remarkable thing is happening in the national health care debate": A group of 12 senators has agreed to "sign on to health care legislation" sponsored by Sens. Ron Wyden (D-Ore.) and Bob Bennett (R-Utah) that is "far more radical than anything the presidential candidates have proposed," Post columnist Marcus writes. According to Marcus, the bill (S 334), called the Healthy Americans Act, "would ... blow up the existing health insurance system." The legislation is "based on the premise ... that covering everyone is required for getting costs under control" and has "something for everyone to dislike," she writes, adding, "No one -- not even Wyden and Bennett -- agrees with every aspect of their proposal" (Marcus, Washington Post, 2/27).