O'Neill and Healthcare Improvement

One of my favorite guys to advance the efforts on healthcare improvement is former US Treasury Secretary and Captain of Industry, Mr. Paul O'Neill. Most will remember Mr. O'Neill's brief stint at President Bush's Secretary of the Treasury and others as the CEO of Alcoa. However, for a few of us that cut our teeth on quality in Pennsylvania in the days of W. Edwards Deming, Myron Trybus and others, Mr. O'Neill reminds us of the constancy of purpose with which we must rely to effect real change. The below story is but the latest in a long string of efforts to address real change. If you want to learn more about the regional quality improvement efforts in S.W. PA, go to: http://www.prhi.org/


From: Pittsburgh Post-Gazette March 10.2006

O'Neill proposes health care fix
Thursday, March 09, 2006

By Maeve Reston, Post-Gazette National Bureau



WASHINGTON -- Former Treasury Secretary Paul H. O'Neill told senators yesterday that the Bush administration and Congress should stop "tinkering at the edges" of America's health care problems with tax policy, and instead outlined a proposal that he believes would dramatically improve the nation's health care quality.

Mr. O'Neill testified at a Senate Finance Committee hearing where Chairman Charles E. Grassley, R-Iowa, asked witnesses to assess whether the United States has been "getting its money's worth" from health care tax expenditures that he expects to cost $2 trillion over the next 10 years.

Mr. Grassley, one of the Senate's chief tax policy writers, said the nation will spend $2.1 trillion on health care this year -- a figure expected to double by 2015. He questioned whether more health care tax incentives, such as expansion of the health savings accounts as proposed by President Bush in his State of the Union address, address the burgeoning costs.

"We want to believe that if we just spend more money or provide more tax subsidies, our problems will magically disappear," Mr. Grassley said in a statement. "Before we add more tax subsidies, we first should look to see if we can make the incentives we have today work better."

Mr. O'Neill has long argued that addressing health care with tax incentives is an inadequate approach. "When they're talking about tax credits, they're talking about our money, not their money," he said in a phone interview last night. "When you use tax credits and deductions, unless they are refundable, ... they're very inequitable, because the value of the credit or deduction depends on the level of income or wealth accumulation an individual has."

Mr. O'Neill said Congress should pass a law requiring all Americans who make more than $30,000 a year to purchase catastrophic health care coverage for themselves and their families, with fewer deductibles and co-insurance payments. The government would then use general revenue funds to purchase health insurance coverage for lower-income people, he said.

A second part of his initiative would create a commission to examine flaws in the health care pricing and reimbursement systems. And the plan would require the government to set national performance goals for health care institutions at "the limit of what is theoretically possible," he said, to try to eliminate costly medical errors, such as infections that begin in hospitals.

The effort should start, Mr. O'Neill said, with a case study of five high-achieving American hospitals, looking at how well they perform when measured against perfection to identify problems and how services can be more efficient.

Mr. O'Neill said he based components of his health care proposal on his experience as CEO of Alcoa, as well as on the work of Pittsburgh-area health professionals like Dr. Rick Shannon, chief of medicine at Allegheny General Hospital.

Once Dr. Shannon directed his staff to reduce one kind of infection in an intensive care unit by 95 percent, Mr. O'Neill said, the ICU was able to achieve that goal within 90 days and has sustained the lowered infection rate for more than two years. By spreading those methods to other ICUs, Mr. O'Neill said, the hospital saved $2 million.