Ex-Medicare chief criticizes Obama, McCain health care plans

In order to make health care affordable, the system needs more efficiency — not just more cash or tax credits, Mark McClellan, former administrator of the Centers for Medicare and Medicaid Services, told a crowd of more than 200 statisticians on Monday.

McClellan, a former associate professor of economics at Stanford University who has studied health care costs, was the keynote speaker for the five-day Joint Statistical Meetings conference. The annual conference, which attracted more than 5,000 statisticians in a variety of fields from across the country to the Colorado Convention Center, was organized by the American Statistical Association.

Neither presidential candidate’s proposed health care reform will pay for itself, but the real long-term solution to making health care more affordable is to make the system more efficient, a goal shared by both presidential candidates, said McClellan, brother of former White House Press Secretary Scott McClellan.

Mark McClellan (Photo/Brookings.edu)

McClellan envisions an “electronic infrastructure,” built by private-public partnerships, that could collect data and make it available for analysis about which treatments are most effective for which patients.

“I think we’re headed for a new era of health care reform, one in which health care coverage reform is no longer separated from health care delivery reform,” he said.

Although health care reform has taken a back seat to the struggling economy and the price of gas, McClellan said the next Congress and presidential administration will still be expected to tackle the issue.

Democratic Sen. Barack Obama’s plan to roll back tax cuts to the country’s wealthiest Americans and instead use the money to expand health care will save only about $50 billion a year, McClellan said, and won’t cover the rising price of health care for uninsured and underinsured Americans.

The cost of health care rose 6.7 percent in 2006 to $2.1 trillion and continues to increase, according to the American Medical Association.

Republican Sen. John McCain hasn’t proposed any significant health care spending but has proposed putting a cap on employer health care spending and using the additional revenue to pay for a health care tax credit for those residents who don’t get health insurance through their jobs, which still wouldn’t cover the rising cost of health care, said McClellan.

The federal budget, which will be almost $500 billion in the red next year, won’t have extra cash to finance increases in health care, added McClellan, who also served as the commissioner of the Food and Drug Administration under President George W. Bush and Deputy Assistant Secretary of the Treasury for Economic Policy during the Clinton Administration.

Both presumptive nominees are talking about health information technology, preventive medicine and reduction in medical errors, McClellan said. “They are increasingly talking about changing the way health care is delivered.”

In his opinion, that’s the right approach, starting with widespread data sharing between health organizations that would allow better comparison of the effects of medications and procedures on different kinds of patients and more quickly alert medical professionals when there is a problem with a new medication in a certain type of patient.

David Scott and Andrea McAllister, both health care statistics analysts for Highmark Blue Cross and Blue Shield in Pittsburgh, said they were already familiar with the arguments for improving the efficiency of health care.

McAllister said she was glad the speech was given to a room full of statisticians, most of whom probably weren’t as involved in health care as she and Scott.

And said Scott:

“Pretty much everything he’s talking about we hear over and over again. … We’ve got to provide efficiency, the system is going broke … We’re not playing the game right in terms of the economics of it so we’ve got to be more efficient, promote long-term wellness, that sort of thing."

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