New Clinton Panel to Study Quality of U.S. Health Care

President Clinton plans to announce today that he is creating a commission to conduct a major study of quality and consumer protection in health care, looking closely at the activities of hospitals, doctors and health maintenance organizations, officials in the Clinton administration said.

The 20-member commission will be led by Health and Human Services Secretary Donna Shalala, and Labor Secretary Robert B. Reich, the officials said. Its members will include health care providers, employers, workers in the health care field and industry experts.

The commission will “have a narrow focus, looking at the rapidly changing health delivery system,” said an administration official. “Is quality in any way suffering? Is there anything the federal government should be doing about it?”

Unlike previous administration health policy efforts, the commission will not discuss the problems of health care costs, or the growing numbers of Americans who are uninsured.

Instead, the focus will be on examining quality of care for the millions of Americans who are often confused by the rapid changes in the world of managed care. Increasingly, Americans are becoming members of HMOs or other networks with prescribed lists of doctors and hospitals.

And the health providers are often paid a fixed monthly fee for each patient, instead of the old system with separate charges for each visit, test and procedure.

As health insurers and HMOs become hard and demanding bargainers, hospitals and doctors are coming under increasing financial pressure.

“There may be so many consolidations that there is no longer a hospital in a particular area, or no community health center,” an administration official said. “That means you can have insurance coverage without access to health care in your area.” The commission will examine the impact of mergers on health care access and quality.

The commission is to deliver an interim report in a year, and a final set of recommendations in 18 months. It will be nonpartisan, capable of working with either candidate who is elected in November, the official said.

The president will disclose plans for the commission when he addresses a rally of senior citizens in Sunrise, a Florida city west of Fort Lauderdale. Sunrise is heavily populated by retirees from the Northeast.

Consumers worry about the potential clash between cost and quality. The old system, fee-for-service, with doctors charging for each procedure, visit and test, had incentives for doctors and hospitals to do too much--too many operations, tests and procedures. The new system, under which doctors often get a fixed fee each month for each patient, encourages too little treatment, critics say.

However, the appointment of the commission “should not be viewed as an attack on managed care,” one official said.