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 DETROIT, Sept. 22 /PRNewswire/ -- Reaction to President Clinton's Health System Reform Plan from the nation's largest health care providers is generally upbeat and cautiously optimistic, according to Gail L. Warden, president and chief executive officer of the Detroit- based Henry Ford Health System (HFHS). Though recognizing large open- ended questions about financing and the massive overhaul of America's seventh-largest industry that the president outlined for the nation in his speech to Congress Wednesday evening, Warden and other health care leaders foresee a future under reform that can be better for patients and acceptable to most hospitals and physicians.
 As one of Michigan's largest health service organizations and employer of approximately 15,000 health care workers, HFHS is positioned as well as any company to meet the cost-containment and access challenges that reform will entail, according to Warden. Reflecting on his more than 30-year career in health care, Warden expressed confidence that health reform has finally reached the top of the national agenda.
 "I have never felt more positive about the likelihood of much-needed change actually happening," he said, adding, "I think President Clinton deserves credit for bringing the health care issues forward in a way that most people can understand, and we appreciate the president's call for open dialogue and a bi-partisan process."
 Congress begins hearings on the president's Health System Reform Plan later this month, signaling the start of a lengthy process that will produce a comprehensive reform package.
 "We have seen the problems of access for low-income people, lack of coverage for people who have lost jobs or are afraid to change jobs due to uncertainty about coverage, and the steadily escalating cost get worse and worse over the past several years," Warden said. He believes that fundamental change is inevitable because voters are unhappy with the status quo. "The last election produced the political will in Congress and a president's leadership to take on the difficult problems," Warden said.
 While he is supportive of the general direction taken in the president's plan, Warden expressed reservations about some features of various legislative proposals currently before the Congress for consideration, including President Clinton's Health System Reform Plan. "At this stage of the game, there is a lot to be pleased about, and there is a lot to be concerned about," Warden said.
 Examples of reform elements he believes have gained consensus and have secured broad support are: a commitment to universal coverage; maintaining and expanding coverage for most workers through the existing employer-based financing system; and insurance reforms that prohibit health plans from excluding people with existing medical conditions, making sure that people don't lose coverage when they become ill. These reforms are in the president's plan.
 Warden commended the president for specifically dealing with the malpractice issues. "We have worked hard to get recognition that cost and access are severely affected by the malpractice climate in parts of this country, especially in Michigan," he said. "We are also pleased to see much-needed anti-trust reforms in the president's plan," Warden said, noting that the changes will make it easier for hospitals and physicians and other providers to create a seamless continuum of high- quality care at an affordable cost.
 For the Henry Ford Health System, the list of health reform concerns includes substantial cuts to Medicare and Medicaid that the president and some members of Congress want, in order to fund universal coverage without increasing taxes.
 "I don't think the country can sustain cuts in the public programs on the magnitude of $238 billion over the next five years," Warden stated, noting that the recent deficit reduction agreement between President Clinton and the Congress has already taken $58 billion from Medicare and Medicaid in essentially this same time period. "This is not to say that substantial savings from reform won't be realized. But I don't think you will get the savings as fast as the next five years, and I don't think they will be large enough to justify this level of cutback to our public programs."
 Warden and other health care leaders are similarly worried about the president's approach to cost control through global budgeting, which would limit health care cost increases to a formula involving growth in the Consumer Price Index. "I think efforts to keep costs in a range that is affordable makes sense," Warden stated. "But this formula- driven approach doesn't allow us to look at the current environment or consider local factors, such as demographics and labor costs, or differences in priorities from state to state or at the community level. The global budget approach fails to reward local cost-effectiveness, and it won't reinforce local incentives for innovation aimed at better value for patients."
 Health care leaders are also cautious about the health purchasing alliances that would be created in each state under the president's reform plan. The new purchasing alliances would not be at risk for managing patient care costs, but would be private or government agencies that would collect the health insurance premiums, would enroll people in one of the various health plan options, and allocate captivated payments to the health care plans. "The alliances introduce a range of troubling questions with regard to their role, their structure, scope of responsibilities and how they will interact with federal and state government," Warden said.
 He is critical of an abrupt shift in the purchasing structure, noting that the alliances are brand-new untried structures that need to be brought up gradually, starting first with the small employer and uninsured populations they were originally intended to help. "The alliances introduce an expensive additional layer of bureaucratic hoops to go through, if they end up as the main purchaser for all consumers," Warden said.
 According to Warden and many of his colleagues nationally, a big plus for the president's proposal are the president's accountable health plans, which compete for enrollment, provide all of the guaranteed health services and are paid with capitation. "The president's vision of a future health system characterized by collaboration among physicians and hospitals, with strict accountability to consumers, mirrors what is already taking place throughout the country," Warden believes.
 He strongly supports preserving consumer choice among accountable health plans, which build on the existing system of options most large employers offer. "The president's accountable health plans are consistent with the kind of delivery system innovation we have been developing," Warden stated, noting that they reflect what the Henry Ford Health System has already been doing for a long time in the organization of HFHS hospitals, physicians and insurance capabilities.
 "We are pleased with the president's private-sector, competitive approach," Warden stated but health care leaders nationally remain alert to potentially heavy-handed government interventions and regulatory structures that bypass local decision-making and may stifle the grassroots delivery system innovations currently occurring throughout the U.S.
 "So far, what we understand about President Clinton's Health System Reform Plan is quite positive, and there is much in it that we can support," Warden said, adding, "At the same time, we also find much to our liking in other major reform proposals that Congress is looking at for the country."
 As the national debate plays out over the next year, Warden believes Congress and the president need to pay close attention to what is happening at the local level. According to Warden, "The real reforms are taking place in health care systems like HFHS as we attempt to become more efficient, as we continue to develop stronger partnerships with physicians and other health professionals, and we continue to reach out and collaborate with other institutions on our shared responsibility for cost-containment and access for low-income under-served communities here in Michigan.
 "Strong leadership of the Michigan congressional delegation in pushing for universal coverage has had positive results at state and national levels," Warden said, at the same time pledging himself and the Henry Ford Health System to continue active participation in raising and resolving the key concerns.
 -0- 9/22/93
 /CONTACT: Rich Swenson, Diana Leone or Doreen Saputo of Henry Ford Health System, 313-876-2882/

CO: Henry Ford Health System ST: Michigan IN: HEA INS SU:

SM-MI -- DE030 -- 4937 09/22/93 18:23 EDT
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Publication:PR Newswire
Date:Sep 22, 1993

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