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Stimulus may have big impact on healthcare

Tuesday, February 17, 2009

"You can't fix the economy without fixing healthcare

Dr. David Nash, of the Jefferson University School of Population Health, says the American Recovery and Reinvestment Act, more popularly known as the Obama stimulus package,

Dr. Nash says one key effect will be relief for states being burdened by growing Medicaid costs. The White House says the legislation provides a temporary $87 million increase in the Federal Medical Assistance Percentage, so that no state has to cut eligibility for Medicaid and SCHIP because of budget shortfalls.

The legislation will also subsidize COBRA, the plan that allows workers to keep their health insurance when they leave a job. It provides a 65% subsidy for 9 months, for workers who lost their jobs on September 1, 2008, or later. Those who didn't choose COBRA to continue their benefits can re-apply for COBRA coverage.

Dr. Nash says that helps the unemployed, and will ease "job lock," in which workers cling to unstable jobs.

"These people are petrified that if they leave their job, they're going to lose their health benefit," he says.

He believes it will encourage American workers to go into new industries. "If you were a GM worker, and you knew that if you re-tooled yourself, and went elsewhere you could still get healthcare, you'd do it in a heartbeat."

The measure also includes $500 million for public health, which should mean better community health centers, and more people working in public health jobs.

It will also boost programs that encourage preventive care, such as immunizations, mammograms, and Pap tests.

There's also money to fight hospital infections...

And to get a better handle on chronic conditions -

"Heart failure, diabetes, high blood pressure...this is what's costing America a fortune. We can't continue to do business as usual," Dr. Nash told Action News.

The legislation also puts $20 billion dollars towards getting more doctors to use electronic medical records. Experts say that will save money and lives.

"It will improve coordination of care, improve safety, decrease errors, decrease waste," says Dr. Nash.

But Dr. Nash says the Obama plan won't do it fast enough. "They want 90% of doctosd engages in 10 years. We need 90% engaged at the end of 2 years."

The program will provide financial help for the small doctors' practices, to help them ease into the digital era. At the moment, it can cost $50,000 for one practice to convert to electronic records.

The most controversial portion of the plan centers on the establishment of an office for "comparative effectiveness," to determine which medical treatments work the best. Under the legislation, $1.1 billion will be set aside for that research on drugs, medical devices, surgery, and other treatments for specific conditions.

Critics say it will lead to "rationing", denying healthcare because it isn't considered cost-effective. Dr. Nash disagrees. He says there is already a lot of de facto rationing, based on race, gender, and geography. He believes this would erase many of those barriers, equalizing care for patients.

"If you don't have a healthy, well-educated workforce, how can you fix the economy," said Dr. Nash.

To see where the money will go, click here .

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