BY: JEFF TIEMAN
Health reform is now approaching its six-month birthday. Catholic hospitals and long-term-care facilities are among the many groups scrambling to understand what the young law means for their operations and patients. As one question is answered, several more are raised. Achieving health reform was a major victory for the American people and for those who are vulnerable. It was a victory, as well, for the Catholic health ministry after so many years of work to build a health care system that reaches everyone, protects human dignity and delivers medical services with compassion — from conception to death.
Although it is true that the reform law achieves many of the Catholic health ministry's objectives for expanded coverage and protection of the most vulnerable, the reform effort is far from over.
To begin, the law will be implemented in stages over the coming years. Many of the provisions tucked into its more than 1,000 pages will not be translated into regulations for many months. Regulations put the law into practical effect, but before regulations are made final, the federal government accepts comments on the proposed rules. This means Catholic hospitals, nursing homes and other health care providers have an opportunity to continue shaping the law and the ways it will affect patients and those who treat them.
CHA and its members always have worked to influence regulations pertaining to Medicare and Medicaid, hospital quality and a host of other issues affecting hospitals and beneficiaries. That work is extremely important now. The success of reform depends in large part on the ministry's continued voice on behalf of responsible and effective regulations that "bring the law to life," as former CHA Board Chair Colleen Scanlon recently put it.
In addition to the rule-making process, it is also important that the law be constantly monitored for its effects on the ground as health care providers, Catholic hospitals and facilities see what is working and what is not, what needs improvement and what gaps still need to be filled. Lawmakers and regulators need that real-time feedback as they evaluate and work to improve reform in coming months and years.
Another important task is continuing to persuade the public that the reform law is a positive thing for our country and the people who live here. Challenges from critics of change and defenders of the status quo abound. Several states are resisting implementation of parts of the law because their leaders disagree with it politically. Meanwhile, falsehoods about what reform does and does not do continue to dominate the airwaves and the Internet, providing inaccurate or intentionally misleading information to a justifiably confused public.
Eventually, in my view, reform will become as popular as Medicare or the Medicare drug benefit, both of which faced criticism and skepticism before they proved to be valuable programs for seniors.
All of us in Catholic health care, however, will need to step up, speak out, explain the law and its implications to our patients, communities, board members, sponsors and others. We will need to continue combating misinformation and speaking up for those who cannot speak for themselves.
Over the coming months, CHA will provide resources to help communicate the benefits of health care reform to the constituencies the ministry serves and works with. We also will continue our work in coalitions with like-minded organizations to help advance a positive, forward-looking message on health reform and how it will improve the lives of our families, friends, colleagues and neighbors.
There is no shortage of work to do. In the most recent opinion survey conducted by the nonpartisan Kaiser Family Foundation, 55 percent of those polled said they are "confused" about the health reform law, and 56 percent said they don't have enough information to understand how it will affect them personally.
Despite the projection by the Congressional Budget Office that reform will reduce the deficit over the next 10 years (and beyond), 45 percent of Americans surveyed think the deficit will increase. Overall, and perhaps most importantly, some 40 percent of poll respondents said they have an unfavorable view of the new law.
It is interesting that when you ask people if they support various provisions of the law — availability of state insurance exchanges, no more denials of coverage due to a pre-existing condition, expanded Medicaid — they express broad approval. It is not so much the content of the law with which people disagree, but rather the way it has been framed by those eager to see it fail.
The coming months and years will be very challenging — and rewarding — as the reform law is implemented and its effects are felt. During this time, each of us can continue to speak up for a health system that works as well as possible for the people who deliver and receive care.
Health reform and its impact on Catholic health care is important but not as important as the daily work of the ministry to serve communities and provide people with quality, effective, compassionate care.
JEFF TIEMAN is senior director, health reform initiatives, Catholic Health Association, Washington, D.C.