- The Washington Times - Thursday, September 22, 2005

There will be time enough — at the right time — to re-evaluate the nation’s preparedness for natural disasters. But today, America is waging a war against disease and illness at home.

The public and private health system in New Orleans and other communities in the Gulf coast region have been wiped out. Federal support will be required to reconstruct and enhance health-care facilities and patient care in the region, particularly for those previously underserved by what was washed away.

Many in Congress are using this public health crisis to seek huge — and permanent — expansion of existing federal health programs to oppose fundamental reforms of Medicaid. We must avoid the nationalization of the health-care system that followed in Europe after the devastation of World War II. Rather, the government should help make medicine more personalized and portable.

Federal dollars should support the creation of a system of electronic patient records and to provide consumers with tax credits and vouchers for purchasing health care coverage that travels with them, just as their cell phones do. Indeed, the best untold story of the Katrina response is how health information technology and vouchers have been used to make health care immediately available and, ultimately, portable.

All survivors will be eligible for Medicaid or state-run children’s health plans and can sign up in a matter of minutes through computerized or online registration. Federal and state governments have issued vouchers to patients to pay for prescription drugs and other survives in the interim. The Public Health Service is using online technology and links to major health sites such as WebMD and Medscape to recruit and deploy thousands of physicians, surgeons, and psychologists at a per-diem basis who will be deployed as local need requires.

Many managed care plans have waived all sorts of restrictions: Wellpoint Health Care will cover any doctor or hospital — without restrictions — willing to provide care. Even as Congress considers trying to save Medicaid money by charging the poor a co-pay for their drugs, Wellpoint is eliminating them to insure that people actually get the medicines they need.

The Red Cross throughout the hurricane-struck region is creating electronic patient record systems. A network of satellite phones, wireless laptops, portable, tripod-mounted satellite dishes were used for medical communications. Volunteers set up Internet-based fax machines and mobile servers that enabled the Red Cross to compile and transmit digital records for each person treated.

Sustaining medical assistance in the wake of Katrina will require more money, but funds should not be used to simply expand existing entitlements. The goal should be to allow people to carry medical information and health insurance wherever they settle. The Department of Health and Human Services can accelerate the effort to establish wireless and Web-based communication systems in conjunction with electronic patient records. It should make its new EPR software available and create a public-private health information technology (IT) “strike force” to obtain, install and operate the systems. It should allocate demonstration grants for health IT to the Katrina relief effort. This would supplement the nearly 3000 Red Cross IT volunteers spread out throughout the South.

While the Federal Emergency Management Agency is creating electronic patient records for each survivor, inexplicably it is going to simply dump the data in a month or two. Why not turn the data and systems over to private providers who can use it to promote continuity of better care for the long haul? Second, reimbursement should reward improved coordination of care. HHS Secretary Mike Leavitt is giving states the freedom to design Medicaid programs to respond to the crisis. He should also reimburse for disease management paying for treating the whole patient — not just specific products and procedures.

Finally, health insurance should be made portable. As people travel from place to place to find jobs and rebuild their lives, they should not have to apply and reapply for insurance. Each family or individual should be given debit cards to pay for health care and insurance premiums. They should be able to buy coverage from anywhere in the country at a group rate. To support this latter change, HHS should create a catastrophic fund in cooperation with the affected states to encourage health plans to participate in the face of potentially expensive claims.

Long after the headlines fade, America must maintain the will and resources to help its citizen restore and rebuild their lives. As Ronald Reagan told the nation after the Challenger disaster: The future doesn’t belong to the fainthearted; it belongs to the brave. To help the brave survivors of Katrina, our nation must not be fainthearted or unimaginative in response to their health concerns. Let’s create a personalized and portable health system that responds to their specific needs, not a political urge to perpetuate existing programs.

Robert Goldberg is director of the Manhattan Institute’s Center for Medical Progress.

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