In the article "For Republicans, Health Reform Is 'Just Beginning' " (Jan. 22), a reference was made to "managed care" as a recommended practice. I actually advocated for "coordinated care," which is very different. In the 1990s, "managed care" became associated with denials for doctors, hospitals or treatments because they were "out of network." As a state senator, I authored Pennsylvania's Patients Bill of Rights, outlawing many of these practices.
Coordinated care is very different. Using evidence-based medicine, doctors and nurses coordinate very complex medical care for people with chronic illnesses like diabetes, hypertension and congestive heart failure. Also called "disease management," coordinated care ensures that patients follow through on prescriptions, therapies, lab work, diet, treatments and post-surgical care. For example, nurses help to keep diabetics' glucose levels in check, thereby avoiding costly complications and rehospitalizations for vision loss, amputation and kidney failure.
The sad irony is that the health care bills passed by the House and Senate cut $500 billion from Medicare, eliminating the disease management programs run by Medicare Advantage insurers. With chronic illness consuming 75 percent of all health care spending and 95 percent of Medicare's budget, these cuts may be penny-wise but pound-foolish. Medicare and Medicaid will pay for hospitalization and surgeries, but not the coordinated care necessary to prevent costlier complications.
In October 2007, researchers with the Partnership to Fight Chronic Disease concluded that chronic illness costs the economy $1 trillion. But in fewer than 15 years, broader use of prevention, early diagnosis and chronic disease management programs would decrease treatment costs and increase productivity by $1.1 trillion annually.
It might also save Medicare from impending bankruptcy.
U.S. REP. TIM MURPHY
Upper St. Clair
The writer is a Republican representing the 18th Congressional District.