Consumers Union Priorities for Health Reform

Consumer friendly: Create a better insurance marketplace
• Through a new insurance exchange, require clear ‘apple-to-apple’ comparisons so consumers can easily shop by providers, quality and price among public and private insurers. Reduce the number of small variations in insurance plans so consumers have meaningful choices when selecting coverage.

• Obtain real savings by having insurers bid based on cost and quality to participate in the insurance connector program, ensuring manageable levels of meaningful health plan options.

• In any annual open-enrollment period, provide easy-to-use insurance price and quality comparison data.

• Create and fund an Office of Consumer Health Services in HHS that expands the State Health Insurance and Assistance Program, and through grants to community-based, non-profit organizations provides consumers with information about insurance issues and policies, maintains an insurance information and complaint hotline, compiles federal and state data on insurance complaints, provides data on insurers’ quality, and ensures standardization of insurance definitions and forms.

Improve quality: Save lives and money
• Encourage providers to prevent deadly hospital-acquired infections by requiring public reporting of infection rates. These preventable infections annually kill up to 100,000 people and cost the healthcare system up to $45 billion to treat.

• Help end medical errors by adopting a version of the Institute of Medicine’s report, To Err Is Human, and require public reporting of ‘never-event’ errors (e.g., surgery on wrong site).

• Reward quality and efficiency by creating a new payment system for hospitals and doctors under the budget proposal by bundling payments for episodes of care, improving hospital discharge planning, and denying payment for hospital re-admissions within 30 days due clearly to poor quality care. Estimated savings: $26 billion over 10 years.

• Allow our nation’s Emergency Rooms to return to top-flight care by adopting the IOM Emergency Response System recommendations. Require coordination among ERs, and tie Medicare capital payments for hospitals to adoption of ‘best practices’ in new ER construction.

More choice: A public plan option
• Provide Americans the choice of a high-quality public coverage plan available through the insurance ‘exchange’ that competes with private health plans to improve savings and gives priority to quality and service. The public plan option should maintain the highest standard of patient and provider satisfaction, and develop innovations that improve the quality of care, reduce costs and eliminate waste.

Put science to work: Help doctors, patients make better decisions
• Ensure doctors have independent information to compare the effectiveness of medical treatments for their patients by creating a permanent, all-payer Comparative Effectiveness Research trust fund similar to the provisions in HR 3162 (110th Congress), with special attention given to identifying and reducing health disparities.

• Expand existing AHRQ programs to disseminate the results of CER research to medical providers and consumers. Fund research into the “best practices” of disseminating such research, and use CER data in easy-to-read ‘drug fact sheets’ on prescription-drug labels.