[Congressional Record Volume 140, Number 63 (Thursday, May 19, 1994)]
[Extensions of Remarks]
[Page E]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: May 19, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
                    ASSESSMENT OF HEALTH CARE REFORM

                                 ______


                          HON. GERRY E. STUDDS

                            of massachusetts

                    in the house of representatives

                         Thursday, May 19, 1994

  Mr. STUDDS. Mr. Speaker, today I rise to introduce the Health Care 
Reform Assessment Act of 1994. Whatever health reform plan is 
ultimately enacted--and I believe we must enact major reforms this 
year--should include provisions to evaluate its impact on the public. 
This bill would establish a two-pronged approach to assessing the 
impact of major health reform changes on the American people.
  First, this measure would produce an assessment proposal for health 
care reform. This assessment proposal would include a detailed 
framework, using a prospective, longitudinal study design, to assess 
progress toward our national goals of health care reform. Second, it 
would perform a baseline assessment of our health care system.
  The first provision would direct the Secretary of Health and Human 
Services to enter into an agreement with the Institute of Medicine of 
the National Academy of Sciences or another nonprofit, nongovernmental 
organization or consortium of institutions to study the impact of 
health care reform legislation at the national, regional and State 
level.
  Under such an agreement, the Secretary would require the organization 
to report to the Secretary and Congress within 18 months after 
enactment with recommendations regarding the following:
  First, indicators of national progress toward the goals of health 
care reform, as determined by the reporting organization. Among the 
goals to be considered would be security, simplicity, savings, 
responsibility, quality, choice and health status.
  Second, one or more study designs for assessing the impact of health 
reforms on these indicators.
  Third, study designs that include comparison of different approaches 
to health care reform, such as single payer and managed competition 
models, that may be used by various States or regions, as well as 
approaches that may be used by Federal agencies, such as DOD and VA, 
and various international approaches.
  Fourth, data elements and public and private sources for obtaining 
data to reflect the indicators.
  Fifth, any special requirements or authority necessary to permit 
access to otherwise confidential data and assure continued 
confidentiality of such data.
  Sixth, approaches for obtaining data that would be useful but are not 
currently available.
  Seventh, approaches to establishing a core set of primary data as 
part of a national data collection effort that could overlap with the 
assessment of health care reform.
  Eighth, the relationship between Federal, State, and local agencies 
to gather, report and share information on health care reform and its 
assessment.
  Ninth, the nature, scope and frequency of reports that would best 
serve the Secretary and Congress for evaluating health reform efforts.
  Tenth, estimates of the overall costs associated with such a study 
and each of its components.
  Eleventh, ways that such a study's findings could be used by various 
groups, such as patients, providers, insurers, employers, taxpayers and 
various government agencies.
  The measure would authorize $1,000,000 for the Secretary to undertake 
the assessment proposal.
  Second, this bill would authorize a baseline assessment of the 
current status of our health care system. The purpose of this baseline 
assessment would be to establish a benchmark for assessing the short- 
and long-term impacts of efforts to reform our health care system at 
the national, regional, and State levels. Such a baseline assessment is 
essential for an accurate, prospective assessment of the impact of any 
major health reform measure.
  The Secretary would enter into an agreement with the Institute of 
Medicine or another nonprofit, nongovernmental organization or 
consortium of institutions to develop baseline information to measure 
access to quality and cost of health care and the health status of the 
American people.
  The Secretary would require the organization to conduct a detailed 
study and report to the Secretary and Congress within 30 months after 
enactment with information and assessments regarding the following for 
public and private, institutional and ambulatory, acute and long-term 
care, physical and mental health services:
  First, the levels of access by the public to the full range of health 
care services.
  Second, the levels of quality of care received by the public.
  Third, the cost of health care services provided to the public using 
various measures, such as the cost of services, the cost of treating 
various conditions and the average and marginal cost of maintaining and 
improving health.
  Fourth, the health status of the public, as a whole and by population 
subgroups.
  The Secretary would be required, to the extent reasonable, to enter 
into agreements with the same organization to conduct both the 
assessment proposal and the baseline assessment so as to facilitate 
maximum cooperation and coordination in the performance of both 
studies.
  The measure would authorize $3,000,000 for the Secretary to conduct 
the baseline assessment study.
  The Institute of Medicine has recommended that an independent 
organization conduct periodic evaluations of any health reform plan 
that is ultimately enacted in a manner that would be independent of 
government regulation or control. This measure would provide for such 
an independent study. It would provide valuable information on an 
ongoing basis for residents of Massachusetts and the Nation as to the 
impact of health care reform on their health and welfare, as well as 
the financial impact of these changes. The cost of this measure would 
be minuscule compared with the enormous benefits that could be derived 
from this essential information.
  I urge my colleagues to support this bill.