Tuesday, October 21, 2008

The Presidential Candidates in JAMA

Tomorrow's issue of JAMA has statements from the two presidential candidates about their healthcare plans. In reading the two statements, I noticed two things. The first is that neither plan addresses exactly how it will improve outcomes (except to say that this needs to happen). The other thing is that both clearly feel that healthcare reform is needed. This is good news for our group.
When discussing his plan, McCain says:
We must find better ways to diagnose, manage, and—most importantly—prevent chronic conditions such as cancer, heart disease, high blood pressure, diabetes, and asthma. Many of these chronic conditions are linked to the epidemic of obesity in our country, which is growing at a particularly alarming rate among children. We must find innovative ways to draw on our public health infrastructure, invest in early intervention programs, and find new models to promote healthy habits and begin to roll back these troubling statistics.

He doesn't give any solutions but the very fact that he states that we should "find innovative ways to draw on our public health infrastructure", "invest in early intervention programs" and "find new models to promote healthy habits", is very encouraging that he will be receptive to our model.
Obama's plan does seem to have a bit more detail regarding how it may affect outcomes, but I think that there are some undiscussed assumptions about how well "Requiring disease management programs and integrated preventive care" and "Devoting more of our health care funds to prevention" will really work in the current system. As previously discussed, David Katz points out that even when preventive services are available, people generally do not take advantage of them unless one can build in a good incentive within the system. The HPfHR system's structure will allow for built in incentives (such as receiving Tier 2 coverage if one completes 80% of Tier 1 preventive care goals) without necessarily requiring a larger amount of funds.
So it seems that who ever wins this election, there does appear to be some role for our plan.
Gil

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