Grades to transform US healthcare, secretary says

WASHINGTON, Nov 14 (Reuters) A scorecard that lays out how well a hospital or doctor does on a treatment -- and how much they charge for it -- can help transform US health care, Health and Human Services Secretary Mike Leavitt has said.

Leavitt said the federal government will urge private insurers and employers to help develop and use such a scorecard so patients can make informed choices on where to get care and who to get it from.

He said Medicare's prescription drug benefit plan serves as a perfect model for such a scorecard.

''It's working. People are happy. They are enrolled,'' Leavitt yesterday told reporters. ''We believe that if you give people choices, they make good choices.'' Democrats and other critics have assailed the Medicare plan as a boon for drug and insurance companies and say it is confusing for the 43 million Medicare beneficiaries. Democrats say they hope to make some changes when they take control of the House of Representatives and the Senate in January.

But Leavitt said his plan for a new health system can bypass Congress by going straight to the employers and insurance companies that provide the great bulk of health benefits.

''We talk a lot about the health-care system,'' he said. ''We don't have a health-care system. We have a health-care sector. We have to change it from a sector to a system.'' The way to do that, he said, is to provide clear data. His for-example model showed the cost of a hip replacement operation at several Florida area hospitals, with charges ranging from 11,600 dollars to 20,700 dollars.

'ASSESSMENT OF CARE' Insurance reimbursement for the operation ranges from 70 per cent to 90 per cent, and the chart shows how much the patient would pay out of pocket. The reimbursement is based on an ''assessment of care'' column, in which the quality of care is rated, although it is not yet clear how this rating would be determined.

''Measuring quality is not an easy proposition but it is doable,'' Leavitt said.

Electronic medical records will be central to the plan so tabs can be kept on each and every procedure, prescription and diagnosis, Leavitt said.

Leavitt said he hopes to work with Congress on some of the provisions, such as a universal electronic medical records system.

Health care is such a touchy topic that it will be important to find common ground and avoid areas of contention -- such as whether the government should provide health care, Leavitt said.

''Everyone just unholsters their political will and aims it at each other,'' he said.

Leavitt said the government has a clear role -- and that should be to manage the overall efforts of private business.

Leavitt will speak on Friday to the Business Roundtable, an association of chief executive officers of big US companies, that is holding a meeting on the issue of health care transparency.

Separately on Monday, America's Health Insurance Plans released their own plan for providing health insurance to 40 million Americans who currently lack it.

The plan would expanding the State Children's Health Insurance Program, make Medicaid available to all uninsured adults with incomes under the Federal Poverty Line and establish a Universal Health Account to allow people to buy health insurance with pre-tax dollars.

Surveys show that health care is consistently among the top five concerns of Americans and that most are unhappy with the current health care system.

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