Bush Order Targets Health Costs

President Bush signed an executive order Tuesday that requires federally financed healthcare programs to gather information about the costs and quality of the medical care they pay for and to share it with consumers.

Speaking in front of a sign intended to underscore his message for television audiences -- “More Choice for Better Healthcare” -- Bush described the order as a step toward lowering the cost of medical care, and eventually the cost of health insurance, by increasing price competition. He also promoted the use of electronic record-keeping, rather than handwritten medical records, as “a practical way to help control medical costs.”

Although Bush’s order applies only to the federal government, its reach could be broad: According to Health and Human Services Secretary Mike Leavitt, the government pays for about 40% of the healthcare provided in the United States.

The agencies covered by the order include the Defense Department, which runs the military’s healthcare program; the Department of Veterans Affairs, which is in charge of the VA hospital system; the Department of Health and Human Services, which administers Medicare and Medicaid, and the Office of Personnel Management, which oversees health insurance plans for federal employees.

Democratic critics said the executive order, which drew praise from a major health insurance association and the National Assn. of Manufacturers, did not directly address the increasing costs of health insurance.

Tuesday’s trip to Minnesota gave the president an opportunity to try to shift public attention from foreign policy issues to a domestic policy matter, albeit one that has not registered high on lists of public concerns this election season. He has returned only occasionally to health policy issues after paying public attention to them at the start of the year.

Bush said that by encouraging greater awareness of the costs of medical treatment, the government could help counter a phenomenon in which, he said, those seeking treatment did not care about the cost because “a third party,” meaning health insurers, were paying for it.

“The U.S. spends more than double that of other countries on healthcare, and yet we still don’t know what we are getting for that value,” said John Engler, president of the National Assn. of Manufacturers, a business lobbying organization.

The executive order requires the four agencies to give participants in their programs information about the payments made to providers and about the quality of healthcare services. It does not apply to private health providers delivering medical treatment paid for by individuals or by private insurance plans.

In effect, Bush said, it tells healthcare providers that “in order to do business with the federal government, you’ve got to show us your prices.”

Left unanswered were questions such as how hospitals would pay for any increased costs they may encounter in establishing and meeting data-sharing standards and how hospitals would demonstrate their charges for specific services.

Karen Ignani, president of America’s Health Insurance Plans, a trade association for almost 1,300 insurance companies, said Bush’s order “rewards the delivery of high-quality care, fosters an inter-operable healthcare system, and takes steps to ensure that consumers are equipped with the best available information they need to make healthcare decisions.”

But the president’s action drew sharp criticism from one of the top Democrats in the state where he appeared.

In a written statement, Brian Melendez, chairman of Minnesota’s Democratic-Farmer-Labor Party, said that Bush and Republican Gov. Tim Pawlenty, who was in the audience, “have done nothing to promote affordable healthcare in Minnesota or in this country, so the president has come to town to help the governor out with a little election-year gimmickry.”

Melendez and a national spokeswoman for the Democratic Party, Stacie Paxton, also criticized Bush for not directly tackling the increases in overall costs for medical care and in the number of Americans lacking health insurance.

Since 2000, according to the Democrats, premiums for employer-sponsored health plans have increased by 73%, and the percentage of small firms offering health insurance for their workers had dropped from 52% in 2004 to 47% in 2005.

The president presented the program at a healthcare forum in this Minneapolis suburb, where five Minnesotans talked about their efforts to hold down healthcare costs by, among other things, comparison-shopping or, in one case, establishing a network of small clinics specializing in treatment of common illnesses, such as strep throat.

“People are desperate to have some relief” from healthcare costs, Leavitt said.

After the forum, Bush attended a closed-door fundraiser for Michele Bachmann, a GOP state senator seeking the House seat now held by Mark Kennedy, a Republican who is running for the U.S. Senate.

The race for the House seat has drawn extensive attention from senior officials of both parties, with Vice President Dick Cheney and House Speaker J. Dennis Hastert of Illinois appearing here for Bachmann and House Minority Leader Nancy Pelosi (D-San Francisco) helping the Democratic candidate, Patty Wetterling, raise money.