Medicare New Directions in Quality Assurance Proceedings (1991) / Chapter Skim
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20. A Legislator's Response to the Institute of Medicine Report
20. A Legislator's Response to the Institute of Medicine Report
Pages 161-166
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From page 161... ...
I know that your charge was to look at the Medicare system and to think about quality assurance in that program, but one really cannot separate the Medicare system from the rest of health care delivery in our country, because what happens in one system is going to affect other systems. So, although the Institute of Medicine (IOM, 1990)
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From page 162... ...
Nevertheless, a word of caution is needed. I think that Congress is afraid right now to be doing anything with our health care delivery programs after the catastrophic health insurance legislation (the Medicare Catastrophic Coverage Act of 1988)
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From page 163... ...
In that regard, it is distressing to me to see the Congress go every year to the Medicare program to get money to meet the Gramm-Rudman-Hollings deficit reduction targets. Not only is this putting individual physicians and providers of health care in a bind, it is also putting hospitals in a terrible bind, particularly hospitals in rural areas and those teaching hospitals in urban areas that have a large number of Medicare patients.
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From page 164... ...
We are hearing increasingly from patients and physicians that the program is too complicated, the rules are too arcane or obtuse, the red tape is too tightly wound, and the administration is really not responsive. The emphasis is too much on utilization control at the expense of quality assurance.
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From page 165... ...
We need an applied technology for quality assurance. The IOM report has laid out a strategic framework for that, but a great deal of work must be done to develop specific criteria and standards and the data management systems necessary to carry it out.
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From page 166... ...
Here, as in so many things, we will get what we pay for. Third, we must hold parties accountable much more than we have in the past for carrying out quality assurance provisions properly and for providing quality care throughout the program.
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