DOTmed attended day one of last week's World Health Congress in Washington, D.C., a meeting of about 1,400 opinion leaders from the public and private sectors including health plan executives and payors, employers, and government and military administrators.

The event combined a strategic orientation with some breakouts that drilled down to programs and solutions that might be replicated in health care reform efforts. A few officials from the executive branch attended but provided scant insight into the direction that the Obama Administration favors in health care reform.

Dora L. Hughes, M.D., M.P.H., Counselor for Public Health & Science for the U.S. Department of Health and Human Services gave the opening keynote address.
"We are convinced this will be the year we get health care reform done," Dr. Hughes said. "Rising health care costs represent the greatest challenge to our long-term viability." She quoted the President as saying, in the recent White House Healthcare Forum that the question is not whether every American deserves health care coverage, the question is how to provide it.

Dr. Hughes listed recent health care investments and priorities of the new Administration including CHIP reauthorization, health IT, comparative effectiveness research, prevention, community health, and federal workers programs. In terms of a blueprint for policy direction, Dr. Hughes stressed the need for payment accuracy in Medicare and Medicaid as well as pay for performance to improve care and constrain costs.

While no plan for health care reform is yet written, she said that the Administration will take a collaborative approach guided by eight principles including protecting family health, affordability, prevention, quality/safety, portability, choice of doctors, ending ineligibility due to pre-existing conditions, and reducing costs. Notably she did not list universal coverage as among the guiding principles. She did suggest that the President advocates for a public plan but said they are working with Congress and, if the eight principles are met, the President would not oppose a bill solely on the basis of it not being a public sector solution to U.S. health care reform. Reading between the lines, as attendees no doubt tried to do, this left the door open to a private market approach.

A poll of the audience, evenly split between Democrats and Republicans, revealed that 56 percent think the Obama Administration will enact health care reform this year. Forty-four percent do not think so.

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