Coburn Bill Would Create Panel to Oversee Quality

Republicans have criticized Democrats for proposing numerous panels to oversee health care, but one leading Republican health care bill would create its own commission and office to help set medical quality guidelines. And that has raised eyebrows among some conservatives.

The bill, by Sen. Tom Coburn of Oklahoma, as well as companion legislation by Rep. Paul Ryan of Wisconsin, proposes a wide variety of changes to the current health system including changing the tax treatment of job-based health insurance coverage.

But it also would create a five-member Health Care Services Commission and an Office of the Forum for Quality and Effectiveness in Health Care, which would include 15 people nominated by health care organizations and appointed by the commission. The commissioners would be appointed by the president and confirmed by the Senate.

The commission’s goals would include conducting and supporting research into the effectiveness, quality, outcomes and costs of medical services, as well as recommending guidelines and standards and making public its findings.

Commissioners could recommend that the Secretary of Health and Human Services take action against health care providers who don’t comply with updated “standards of quality, performance measures and medical review criteria.” Penalties for failing to comply include fines or being barred from getting paid by federal health programs.

Some conservatives say the legislation goes too far. “A Republican price, quality and transparency panel could easily be morphed into a Democratic comparative effectiveness panel and easily morphed into a Sarah Palin death panel,” says Michael Cannon of the Cato Institute, a libertarian think tank in Washington.

“The Republicans are being a little hypocritical if they’re proposing their own panels on quality and cost savings and then decrying the Democrats for doing the same thing.”

John Goodman of the conservative National Center for Policy Analysis, says “It’s not my view that the federal government can be the primary arbiter of quality.”

During an interview this week with Kaiser Health News, Coburn expressed some surprise that a commission with the power to recommend sanctions against health care providers was included in the proposal. “That’s in my bill?” he asked.

His staff later said the provision is aimed at giving consumers more information on health care costs and quality.

Coburn aide John Hart said the bill would also disband the Federal Coordinating Council of Comparative Effectiveness, a group that was created by the stimulus legislation and has the power to coordinate research comparing various medical treatments. The council will not set guidelines for payment, coverage or treatment.

The Coburn/Ryan bill also would disband the federal Agency for Healthcare Research and Quality, which conducts research into quality, safety, efficiency, and effectiveness of health.

“The Patients’ Choice Act empowers consumers, not a command and control bureaucracy,” Hart said.