HOSPITALS' IDEAS DON'T STOP THINKING ABOUT HEALTH

                         Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: TUESDAY, January 26, 1993                   TAG: 9301260484
SECTION: EDITORIAL                    PAGE: A8   EDITION: METRO 
SOURCE: 
DATELINE:                                 LENGTH: Medium
HOSPITALS' IDEAS DON'T STOP THINKING ABOUT HEALTH
MEMBERS OF the medical community along with a lot of others are anticipating with excitement but also confusion the proposal of health-care reforms promised but not fully explained by Bill Clinton.
The tendency, while awaiting national reform, might be to put state initiatives on hold - but this should be resisted. National legislation should, after all, build on and encourage experimentation in the states. And some good ideas ought to be implemented whatever comes down from Washington.
In the category of good ideas fall several of the Virginia Hospital Association's items on its legislative agenda this year. The association's health-care reform proposals are unlikely to get anywhere this session, but they merit attention nonetheless. Among them:
Community-care networks. According to this proposal, the state would encourage health-care providers to form organizations offering comprehensive health services for a fixed fee. Reduced fragmentation of service would cut costs and improve care in the long run, as would networks' emphasis on primary and preventive care. Insurance premiums would be community-rated, so that the seriously ill could not be excluded from coverage.
Clinical practice guidelines. Sanctioned by the state board of medicine and constantly updated, such guidelines would be derived from physicians' experience on which treatments are most effective for particular ailments. The guidelines would offer a way of sharing data about treatment outcomes. And adherence to a guideline would assure a strong defense against malpractice suits. The guidelines would counteract the defensive-medicine syndrome, by which doctors call for unnecessary tests and treatments to guard against liability.
Consumer reports. The Virginia Hospital Association does not shrink, as some of its members do, from offering more data to consumers to inform their choices in the marketplace. The association recommends an "easy-to-use information system that allows patients and other purchasers of health care to compare prices, costs, outcomes and quality." It's hard to argue the benefits of competition if consumers are kept ignorant.
While the timetable for such reforms isn't clear, either at the state or national levels, it is clear that they should be part of any reform effort that calls itself comprehensive. Virginia lawmakers would do well to ponder the hospital association's package for future action, even if they decide not to act on it this year.

by Bhavesh Jinadra by CNB