Health Absent from State of the Union Speech

Today’s Managing Health Care Costs Indicator is 5

I listened to the State of the Union address last night (transcript) and I was worried my attention had wandered when Obama discussed health care reform – the signature achievement of a very productive first Congress of this presidency.

Turns out I didn’t miss it at all – there was virtually no mention of health care reform in the speech.  Here are the five times he used the word “health.”

Today, the discoveries taking place in our federally financed labs and universities could lead to new treatments that kill cancer cells but leave healthy ones untouched. 

 Because America will develop this resource [gas]without putting the health and safety of our citizens at risk.

 I will not go back to the days when health insurance companies had unchecked power to cancel your policy, deny your coverage, or charge women differently than men.

 Now, I recognize that people watching tonight have differing views about taxes and debt, energy and health care.

 That’s why our health care law relies on a reformed private market, not a government program.

In fairness, there were two mentions of “medical” in the speech, too.  One was about “faulty medical devices,” and the other regarding “medical research.”  It’s hard not to be against one of these and for the other!

There were a lot of opportunities to celebrate in health care over this past year.   Health care premium increases were lower this year, and those of us with young adult children can leave them on our health plan as they weather this terrible job market.  The National Institute of Medicine has confirmed that birth control is an essential benefit.  Massachusetts  continues to retain a high rate of insurance and premiums and costs have leveled out here, too.  Health plans in Texas with low medical loss ratios will have to offer big refunds.  Providers are coalescing to participate in accountable care organizations, and electronic records are proliferating. Public reporting continues to improve, and we’ve discovered that proper treatment of HIV positive patients doesn’t just prolong their high quality lives, but prevents transmission, too.

There’s a lot to worry about too.   Many states are getting nowhere in developing their exchanges, and the Supremes are getting ready to hear oral arguments about the constitutionality of the individual mandate and of federal requirements to maintain future Medicaid funding. EMRs don’t talk to each other, and health care has not become especially patient-centric. The Accountable Care Organizations haven't yet saved money, and there's always a danger they will lead to higher costs through market consolidation.  Health care still costs too much, and advances often lead to very slightly higher quality for a few in exchange for massive increases in cost for all.

Perhaps when all of these issues are resolved health care will feature more prominently in a future state of the union address.

(My post on the CBO “pay for value” demonstration projects isn’t yet complete – hopefully tomorrow)