Posted on April 16, 2009 by David Kopans

President Obama's Executive Order Establishes White House Office of Health Reform

On April 8, 2009, President Obama signed an executive order establishing a White House Office of Health Reform (OHR) that will spearhead the Obama Administration's policy agenda for health care. The principal functions of the OHR include providing leadership for and coordinating the development of the Administration's agenda; working with Congress, various executive departments and agencies, and State, local and community policymakers and public officials; and monitoring the implementation of the agenda.  If requested by the OHR Director, executive departments and agencies are required to designate a liaison to work with the OHR.

The executive order also requires the Secretary of Health and Human Services to establish its own Office of Health Reform within the Department of Health and Human Services to coordinate closely with its White House counterpart.

President Obama has appointed Nancy Ann Min DeParle as the first Director of the OHR. During the Clinton Administration, DeParle served as the Associate Director for Health and Personnel at the White House Office of Management and Budget and as the Administrator of the Health Care Financing Administration, which is now the Centers for Medicare and Medicaid. Before joining the Clinton Administration, she served as the Tennessee Commissioner of Human Services and worked as a lawyer for a law firm in Tennessee. Since leaving the Clinton Administration, DeParle is reported to have served on the board of directors of various medical device companies, such as Boston Scientific and MedCo.

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Posted on February 16, 2009 by Peter Pavarini

The Globalization of Healthcare - Is the U.S. Ready?

As the media warn about the possibility of trade wars and protectionism, the international healthcare consumer has already set the stage for the globalization of  what could become the world's largest industry.

The movement of goods, services and capital across international borders has been well-documented, and it is hard to dispute the impact this has had on the transfer of wealth and multinational interdependence.  What is less understood is how people who seek better, more cost-effective healthcare in foreign countries are re-shaping the market for medical treatment.  As the price of healthcare in the U.S. has skyrocketed, consumers have become more willing to travel great distances to obtain less expensive care.  At the same time, U.S. hospitals have addressed their staffing shortages by recruiting qualified doctors, nurses and other professionals from other countries.

The dynamic that is steering this revolution is quite simple.  In the absence of political or economic barriers, globalization shifts the production of goods and services to those locations that produce such offerings at the lowest possible cost.  In the past two decades, this trend has been greatly accelerated by the availability of information about alternative sources on the internet and by demographic forces such as the aging of  the American population including healthcare workers.

A recent study by the Society for Healthcare Strategy and Market Development and the American College of Healthcare Executives, entitled "Futurescan 2009 -Healthcare Trends and Implications 2009-2014" revealed that nearly two-thirds of survey respondents think it is likely that the number of persons traveling overseas for medical treatment will double by the year 2014; however, an equal percentage don't believe that health insurers will amend their policies to pay for such medical tourism.  An additional 82 percent of respondents agree that existing and new forms of telemedicine will enable even greater degrees of "virtual" medical tourism.  Apparently, the public is confident that technology will increasingly bridge the distances between patients and providers, even though the source of payment remains in doubt.

Which brings us to the crux of this commentary.  Is the American legal system ready for such a fundamental restructuring of the healthcare delivery system?  Will our current economic troubles and the Government's intense desire to put a lid on healthcare costs accelerate globalization beyond the ability of lawmakers, regulators and courts to figure out  what our  rights and responsibilities should be in this brave new world?  These and other questions must be addressed as part of the greater debate about health care reform if we are to build a sustainable model for the 21st Century.

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Posted on January 5, 2009 by Peter Pavarini

Can Healthcare Thrive in 2009 Despite the Economy?

'Tis the season for new year predictions.  Desperate to report some good news, business writers appear to like the prospects for some health care stocks and for new jobs created in the health care sector of the economy.  But can H Street really overcome what's happening on Wall Street and Main Street?

Price Waterhouse Coopers in its advertising supplement to Modern Healthcare entitled "Top Nine Health Industry Issues in 2009: Outside Forces Will Disrupt the Industry" presents a somewhat guarded outlook.  The conclusion reached by PWC: "During 2009, the health industry may prove to be a source of profitable growth during an economic malaise.  As new players continue to enter the healthcare market and new technologies develop, the next frontier in healthcare could be hidden from view.  In addition, heightened focus by regulators will need to be monitored carefully as reducing healthcare costs are viewed as a way to stimulate the economy."   As PWC points out, three of the Top 100 Most Powerful People in Healthcare (AOL founder Steve Case, Google's Eric Schmidt, and Microsoft founder Bill Gates) have not traditionally been seen as captains of the healthcare industry.

Perhaps Americans should hope for some creative disruption by outsiders.  It is not as though healthcare insiders have proven particularly successful in prior reform efforts.  Next on the reading list, former Senator and HHS Secretary nominee Tom Daschle's book Critical: What We Can Do About the Health-Care Crisis.   SZD Health Law Scan will report on that soon.

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