Glenn M. Hackbarth, J.D., M.A., chairman of the commission, lives in Bend, OR. He has experience as a health care executive, government official, and policy analyst. He was chief executive officer and one of the founders of Harvard Vanguard Medical Associates, a multispecialty group practice in Boston that serves as a major teaching affiliate of Harvard Medical School. Mr. Hackbarth previously served as senior vice president of Harvard Community Health Plan and president of its Health Centers Division, as well as Washington counsel of Intermountain Health Care. He has held various positions at the U.S. Department of Health and Human Services, including deputy administrator of the Health Care Financing Administration (now known as CMS). He currently serves as the vice chairman of the board of the Foundation of the American Board of Internal Medicine. He is also a board member at the National Committee for Quality Assurance (NCQA) and at the Commonwealth Fund. He is also a member of the Commonwealth Fund's Commission on a High Performance Health System. Mr. Hackbarth received his B.A. from Pennsylvania State University and his J.D. and M.A. from Duke University.
Will an individual mandate "play in Peoria"? Maybe...maybe not. Americans seem to believe several things that are difficult to reconcile: Most Americans seem to believe that people suffering a serious illness or injury should not be denied medical care. Most Americans also seem to believe that people with serious illnesses should not be denied insurance coverage, or charged exorbitant rates for that coverage. (On other hand, many Americans seem to tolerate people being without coverage due to their economic circumstances; perhaps people with steady jobs can't imagine themselves in economic straits, but they do fear illness.) And, of course, Americans… Read more
In response to David Kendall's post, I want to be clear that that I favor changing Medicare's payment systems so that they better reward high-value care. I think my views, and MedPAC's, on that issue are clear. Nevertheless, I believe (and this is a personal view, not necessarily MedPAC's) that there are limits on what can be accomplished in program founded on the principle of giving beneficiaries free-choice of provider -- and that operates within political constraints. My personal opinion is that the latter could, and should, be loosened somewhat by delegating some decisions to a Medicare Board. But neither… Read more
I agree with Uwe Reinhardt's comments, and I will not repeat them. Having worked in a top HMO and in government, I realize that private plans have strengths -- and so does Medicare. Their respective strengths are different, making competition between them desirable. Private plans have the potential to change patterns of care: substitute outpatient for inpatient care, while reducing unnecessary admissions and readmissions; substitute effective primary care for unduly expensive sub-specialty care; substitute cognitive services for a rote use of expensive imaging. Private plans are better positioned to achieve these goals than Medicare because they have tools at their… Read more
Senator Daschle's proposal for a Federal Health Board deserves careful consideration. (This is my opinion, and it does not necessarily reflect the views of MedPAC. The Commission has not considered the board proposal and has no plans to do so.) I am most interested in the Board's implications for how providers are paid. To achieve a high-performing health care system, we must reform provider payment to reward effective primary care, better care coordination, and better management of chronic illness. Although many people support these objectives in the abstract, their enthusiasm wanes when they realize the large redistribution of income among… Read more
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