Bush Signs Order on Health Care

By Michael A. Fletcher
Washington Post Staff Writer
Wednesday, August 23, 2006

MINNETONKA, Minn., Aug. 22 -- President Bush signed a measure Tuesday ordering federal agencies to do more to inform beneficiaries about the cost and quality of their health-care services, which federal officials hailed as a major step toward bringing greater efficiency to the nation's medical system.

The executive order requires four federal agencies that oversee large health-care programs to gather information about the quality and price of care, and to share that information with one another and with program beneficiaries.

The initiative underscores Bush's belief that the nation's health-care system would be more efficient if consumers could shop for the best care at the best price, administration officials say. "The fact is, if you have excellent information about quality, about service and about price, people make good decisions," Bush said during a roundtable here to discuss the initiative.

With the federal government paying for about 40 percent of the nation's spiraling health-care bill, administration officials said the order requiring federal agencies to develop and share information about the quality and price of care should help bring greater transparency to the business of medicine.

Under the order, the four agencies must establish programs to measure quality of care, a complicated and controversial task that officials said could take years. Beneficiaries must also be able to see the prices that the agencies pay for common medical procedures, to develop and identify practices that foster high-quality care, and, whenever possible, to use compatible computer systems and electronic health records to help track a recipient's medical care and condition. The changes must be underway by Jan. 1.

"If you have an ATM or a credit card, you can use it anywhere in the world and it works, because it's interoperable. Everybody competes but uses the same system, basically, to transact their affairs," Health and Human Services Secretary Mike Leavitt told reporters aboard Air Force One.

"Health care isn't like that. Roughly 85 percent of all health-care records are still paper. So a part of what we'll be talking about today is the interoperability of systems that manage health records."

The order signed by Bush also directs the federal government to identify practices that foster efficient medical care.

The affected agencies include the Defense Department, which oversees the military health-care system; the Department of Health and Human Services, which oversees Medicare and Medicaid; the Office of Personnel Management, which is in charge of the Federal Employees Health Benefits Program; and the Department of Veterans Affairs, which operates the VA health system.

During a roundtable with medical and business executives, Bush touted the executive order as well as other initiatives that he believes could harness market forces to slow the skyrocketing cost of medical care. Since 2000, the cost of employer-sponsored health coverage has increased by 73 percent. More than 45 million Americans lack health insurance.

In addition to his executive order, Bush said health savings accounts, which allow people to save tax-free money to pay for routine medical costs, while insuring only catastrophic expenses, would go a long way to making consumers more interested in the cost of their health care. He also promoted association health plans, which would allow small businesses to join across state lines to buy health insurance.

"I guess if I had to summarize how I view it, I would say there's a choice between having the government make decisions or consumers make decisions. I stand on the side of encouraging consumers," Bush said. ". . . Health-care policy ought to be aimed at bolstering the consumer, empowering individuals to be responsible for health-care decisions -- is kind of the crux about what we're talking about."

Staff writer Christopher Lee in Washington contributed to this report.

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