Wednesday, July 02, 2008

Help Save the Pennsylvania Health Care Cost Containment Council

Before high gas prices and the recession took center stage, the #1 policy issue in the nation was health care. It costs too much, which is making businesses uncompetitive and making it harder and harder for people to afford health insurance, and the quality is unacceptably poor, with thousands of people getting preventable infections in hospitals and failing to get the health care they need to keep them out of the hospital in the first place.

There is widespread agreement across the country that one of the key elements of a solution to these problems is "transparency," an unfortunately non-transparent bit of jargon that means telling people what how much health care actually costs and how good it actually is. And believe it or not, Pennsylvania has been one of the leading states in providing that kind of transparency for over 20 years, through a state agency called the Pennsylvania Health Care Cost Containment Council, or PHC4 for short.

Since 1986, PHC4 has been collecting data, primarily from hospitals, and has been issuing reports comparing hospitals in terms of their profits, their infection rates, their mortality rates, their readmission rates, etc. Over the past few years, PHC4 has done pathbreaking work in publicly reporting on the rate of infections in different hospitals (our own Pittsburgh Regional Health Initiative here in Pittsburgh has proven that most of these infections can be completely eliminated through simple and affordable methods if hospitals make a commitment to doing it, and PHC4 lets you know which ones are making progress); in publicly reporting on the rate of hospital readmissions (did you realize that for many conditions, if you go to the hospital, you have a 1 in 5 chance of having to go back to the hospital within 30 days?); and perhaps most dramatically, in reporting on the dramatic difference in how much different hospitals are paid for doing the same procedures with no difference in quality (should it really cost twice as much at one hospital for a coronary artery bypass as another, with no difference in quality?).

This kind of information is a critical foundation for health care reform. Most states would love to have this kind of information, but they don't. Pennsylvania has it, and you can get access to all of this and other information on the web at

But hurry, because thanks to yet another example of how our state leaders are spending more time playing one-upmanship with each other than trying to really get things done, the General Assembly failed to reauthorize PHC4 before the June 30 deadline. And then, since it apparently had nothing more important to do, the Governor's Office raced right over to PHC4 and laid off almost all of the employees.

Some commitment to health care cost containment the Governor and Legislature have, huh? News accounts claim that PHC4 is a pawn in a battle between the Governor and the Senate over the medical malpractice insurance fund. That would be bad enough, but it wouldn't at all be surprising if it's also because the state hospital association has been trying to get rid of PHC4 for years, since all this transparency about how expensive hospitals are and how good they are at preventing infections is a little -- maybe a lot -- uncomfortable.

Take a look at the PHC4 website and judge for yourself. You can find hospital-by-hospital and doctor-by-doctor rankings on quality, cost, infections, readmissions, etc.

And if you agree that having an agency like this is a good thing, here's what you can do (but do it right now!): Send an email to:
Governor Ed Rendell at
Senator Dominic Pileggi, the Senate Majority Leader at
Rep. Todd Eachus, the House Democratic Policy Chairman at
and ask them to (1) stop playing partisan games with our health care, and (2) reauthorize PHC4 before they go home for the holiday, so the employees who work there won't go find other jobs and leave Pennsylvania without the unique capability it has taken two decades to build.


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