Nellie Bristol

WASHINGTON – American health care could be in for the world's largest customer satisfaction survey, as the U.S. Citizens' Health Care Working Group seeks comments nationwide on how to reform the system.

“In order to make health care work for all Americans, we need to hear from all Americans,” said working group member Rosario Perez, a registered nurse and vice president of Mission Integration and Outreach Services for CHRISTUS Santa Rosa Health Care in San Antonio. “We want to hear from individuals across the country. That means your parents, your relatives, your coworkers, and people in your community.” Perez spoke at a briefing sponsored by the Citizen's Health Care Working Group.

Established by the 2003 Medicare Modernization Act, the 14-member panel will collect as many comments and suggestions as possible before April 15. Submissions will serve as the basis for panel recommendations for Congress and President Bush to consider next spring. The recommendations will address costs, care affordability, and quality improvement.

“Despite increases in medical care spending that are greater than the rate of inflation, population growth, and Gross Domestic Product growth, there has not been a commensurate improvement in our health status as a nation,” according to the law that established the working group.

Among areas of interest highlighted by the working group are consumer concerns about health care delivery, benefits that should be provided, how health care should be paid for, and acceptable trade-offs to ensure broad access to services.

Comments will be collected via the group's Web site (www.citizenshealthcare.gov

The effort is the bipartisan brainchild of Sen. Orrin Hatch (R-Utah) and Sen. Ron Wyden (D-Ore.).

The press briefing was held in the same Senate room as the 1912 hearings on the sinking of the Titanic, and Sen. Wyden said the U.S. health care system could suffer a similar dire fate “if something dramatic isn't done to save it.”

Sen. Wyden suggested that citizen input may engender systemic change that has stymied Congress for 6 decades. A “citizens' road map” for change could help “overcome the feeding frenzy by special interests,” he argued.

The panel is made up of health care professionals, economists, benefits experts, and advocates from across the country, and includes Health and Human Services Secretary Michael Leavitt. The group is chaired by Randall L. Johnson, head of corporate benefits for Motorola Inc.; vice chair is Catherine McLaughlin, Ph.D., a health economist at the University of Michigan.

To jump start the national discussion, the group developed a 30-page “Health Report to the American People,” which summarizes the current state of U.S. health care.

“Having this information prepares us as a country to ask some tough questions about whether we are getting the services we need and want, [and] whether we are getting our money's worth and choices we need and are willing to make to have health [access] for all Americans,” Dr. McLaughlin said.

The working group aims to develop recommendations that would address health care as a whole, she said.

“Our health care system is a lot like our natural environment, an ecosystem in which any significant change in one area has ripple effects throughout the others,” Dr. McLaughlin said. “We need to address the entire health care system, not just specific problems like cost, quality, or access–no matter how urgent they may seem from our different perspectives.”

WASHINGTON – American health care could be in for the world's largest customer satisfaction survey, as the U.S. Citizens' Health Care Working Group seeks comments nationwide on how to reform the system.

“In order to make health care work for all Americans, we need to hear from all Americans,” said working group member Rosario Perez, a registered nurse and vice president of Mission Integration and Outreach Services for CHRISTUS Santa Rosa Health Care in San Antonio. “We want to hear from individuals across the country. That means your parents, your relatives, your coworkers, and people in your community.” Perez spoke at a briefing sponsored by the Citizen's Health Care Working Group.

Established by the 2003 Medicare Modernization Act, the 14-member panel will collect as many comments and suggestions as possible before April 15. Submissions will serve as the basis for panel recommendations for Congress and President Bush to consider next spring. The recommendations will address costs, care affordability, and quality improvement.

“Despite increases in medical care spending that are greater than the rate of inflation, population growth, and Gross Domestic Product growth, there has not been a commensurate improvement in our health status as a nation,” according to the law that established the working group.

Among areas of interest highlighted by the working group are consumer concerns about health care delivery, benefits that should be provided, how health care should be paid for, and acceptable trade-offs to ensure broad access to services.

Comments will be collected via the group's Web site (www.citizenshealthcare.gov

The effort is the bipartisan brainchild of Sen. Orrin Hatch (R-Utah) and Sen. Ron Wyden (D-Ore.).

The press briefing was held in the same Senate room as the 1912 hearings on the sinking of the Titanic, and Sen. Wyden said the U.S. health care system could suffer a similar dire fate “if something dramatic isn't done to save it.”

Sen. Wyden suggested that citizen input may engender systemic change that has stymied Congress for 6 decades. A “citizens' road map” for change could help “overcome the feeding frenzy by special interests,” he argued.

The panel is made up of health care professionals, economists, benefits experts, and advocates from across the country, and includes Health and Human Services Secretary Michael Leavitt. The group is chaired by Randall L. Johnson, head of corporate benefits for Motorola Inc.; vice chair is Catherine McLaughlin, Ph.D., a health economist at the University of Michigan.

To jump start the national discussion, the group developed a 30-page “Health Report to the American People,” which summarizes the current state of U.S. health care.

“Having this information prepares us as a country to ask some tough questions about whether we are getting the services we need and want, [and] whether we are getting our money's worth and choices we need and are willing to make to have health [access] for all Americans,” Dr. McLaughlin said.

The working group aims to develop recommendations that would address health care as a whole, she said.

“Our health care system is a lot like our natural environment, an ecosystem in which any significant change in one area has ripple effects throughout the others,” Dr. McLaughlin said. “We need to address the entire health care system, not just specific problems like cost, quality, or access–no matter how urgent they may seem from our different perspectives.”

WASHINGTON – American health care could be in for the world's largest customer satisfaction survey, as the U.S. Citizens' Health Care Working Group seeks comments nationwide on how to reform the system.

“In order to make health care work for all Americans, we need to hear from all Americans,” said working group member Rosario Perez, a registered nurse and vice president of Mission Integration and Outreach Services for CHRISTUS Santa Rosa Health Care in San Antonio. “We want to hear from individuals across the country. That means your parents, your relatives, your coworkers, and people in your community.” Perez spoke at a briefing sponsored by the Citizen's Health Care Working Group.

Established by the 2003 Medicare Modernization Act, the 14-member panel will collect as many comments and suggestions as possible before April 15. Submissions will serve as the basis for panel recommendations for Congress and President Bush to consider next spring. The recommendations will address costs, care affordability, and quality improvement.

“Despite increases in medical care spending that are greater than the rate of inflation, population growth, and Gross Domestic Product growth, there has not been a commensurate improvement in our health status as a nation,” according to the law that established the working group.

Among areas of interest highlighted by the working group are consumer concerns about health care delivery, benefits that should be provided, how health care should be paid for, and acceptable trade-offs to ensure broad access to services.

Comments will be collected via the group's Web site (www.citizenshealthcare.gov

The effort is the bipartisan brainchild of Sen. Orrin Hatch (R-Utah) and Sen. Ron Wyden (D-Ore.).

The press briefing was held in the same Senate room as the 1912 hearings on the sinking of the Titanic, and Sen. Wyden said the U.S. health care system could suffer a similar dire fate “if something dramatic isn't done to save it.”

Sen. Wyden suggested that citizen input may engender systemic change that has stymied Congress for 6 decades. A “citizens' road map” for change could help “overcome the feeding frenzy by special interests,” he argued.

The panel is made up of health care professionals, economists, benefits experts, and advocates from across the country, and includes Health and Human Services Secretary Michael Leavitt. The group is chaired by Randall L. Johnson, head of corporate benefits for Motorola Inc.; vice chair is Catherine McLaughlin, Ph.D., a health economist at the University of Michigan.

To jump start the national discussion, the group developed a 30-page “Health Report to the American People,” which summarizes the current state of U.S. health care.

“Having this information prepares us as a country to ask some tough questions about whether we are getting the services we need and want, [and] whether we are getting our money's worth and choices we need and are willing to make to have health [access] for all Americans,” Dr. McLaughlin said.

The working group aims to develop recommendations that would address health care as a whole, she said.

“Our health care system is a lot like our natural environment, an ecosystem in which any significant change in one area has ripple effects throughout the others,” Dr. McLaughlin said. “We need to address the entire health care system, not just specific problems like cost, quality, or access–no matter how urgent they may seem from our different perspectives.”

BALTIMORE — Hospitals with specialized capabilities should be subject to the requirements of the Emergency Medical Treatment and Labor Act even if they don't have an emergency department, a federal advisory panel on the EMTALA has recommended.

The EMTALA technical advisory group recommended that the Centers for Medicare and Medicaid Services require specialty hospitals to stabilize emergency patients and accept transfers in their specialties from other hospitals.

“We were speaking to all hospitals with specialized capabilities,” technical advisory group Chair David M. Siegel, M.D., J.D., said in an interview. Dr. Siegel is an emergency physician who serves as a consultant and clinical coordinator for Florida's Quality Improvement Organization.

In a second recommendation, the EMTALA panel voted not to require hospitals with specialized capabilities to have emergency departments.

Although not specified in the recommendation, the EMTALA requirements would apply even if specialty hospitals operate only during limited hours, Dr. Siegel said. That condition was suggested by general hospital groups.

“Many specialty hospitals have limited hours of operation, due in large part to their focus on outpatient services,” Federation of American Hospitals' Vice President and General Counsel Jeffrey Micklos told the panel. “In the best interests of serving patients, we believe that specialty hospitals should not be allowed to refuse to accept transfers on the basis that they lack capacity to treat the individuals simply because they are closed.”

While not addressing the issue of operating hours specifically, ASHA argued that there is no need to adopt any measures applying only to specialty hospitals.

“ASHA firmly believes that our members are subject to the requirements of EMTALA, as they apply to all acute care hospitals,” said ASHA representative Greg Miner. “There is no reason to write new requirements directed at specialty hospitals that merely duplicate the obligation we already have under this law.” Miner is the executive director of Siouxland Surgery Center in Dakota Dunes, S.D.

Both recommendations made by the advisory group were in response to questions posed by the Centers for Medicare and Medicaid Services.

The agency also asked whether specialty hospitals, “irrespective of whether they have emergency departments,” are subject to the EMTALA requirement that Medicare-participating hospitals “may not refuse to accept an appropriate transfer of an individual who requires such specialized capabilities or facilities if the hospital has the capacity to treat the individual.”

The recommendations were acceptable to both ASHA and general hospital representatives.

“It is clear that specialty hospitals are not shouldering their burden to provide critical community health care services, such as emergent care or caring for those least able to pay, but instead are exacerbating an existing problem,” the FAH's Micklos told the panel. “However, the federation does not believe that the best way to address this deficiency is through a federal requirement that specialty hospitals maintain an emergency department.”

Both the FAH and the American Hospital Association testified that the hospitals should be required to accept appropriate transfers, however.

BALTIMORE — Hospitals with specialized capabilities should be subject to the requirements of the Emergency Medical Treatment and Labor Act even if they don't have an emergency department, a federal advisory panel on the EMTALA has recommended.

The EMTALA technical advisory group recommended that the Centers for Medicare and Medicaid Services require specialty hospitals to stabilize emergency patients and accept transfers in their specialties from other hospitals.

“We were speaking to all hospitals with specialized capabilities,” technical advisory group Chair David M. Siegel, M.D., J.D., said in an interview. Dr. Siegel is an emergency physician who serves as a consultant and clinical coordinator for Florida's Quality Improvement Organization.

In a second recommendation, the EMTALA panel voted not to require hospitals with specialized capabilities to have emergency departments.

Although not specified in the recommendation, the EMTALA requirements would apply even if specialty hospitals operate only during limited hours, Dr. Siegel said. That condition was suggested by general hospital groups.

“Many specialty hospitals have limited hours of operation, due in large part to their focus on outpatient services,” Federation of American Hospitals' Vice President and General Counsel Jeffrey Micklos told the panel. “In the best interests of serving patients, we believe that specialty hospitals should not be allowed to refuse to accept transfers on the basis that they lack capacity to treat the individuals simply because they are closed.”

While not addressing the issue of operating hours specifically, ASHA argued that there is no need to adopt any measures applying only to specialty hospitals.

“ASHA firmly believes that our members are subject to the requirements of EMTALA, as they apply to all acute care hospitals,” said ASHA representative Greg Miner. “There is no reason to write new requirements directed at specialty hospitals that merely duplicate the obligation we already have under this law.” Miner is the executive director of Siouxland Surgery Center in Dakota Dunes, S.D.

Both recommendations made by the advisory group were in response to questions posed by the Centers for Medicare and Medicaid Services.

The agency also asked whether specialty hospitals, “irrespective of whether they have emergency departments,” are subject to the EMTALA requirement that Medicare-participating hospitals “may not refuse to accept an appropriate transfer of an individual who requires such specialized capabilities or facilities if the hospital has the capacity to treat the individual.”

The recommendations were acceptable to both ASHA and general hospital representatives.

“It is clear that specialty hospitals are not shouldering their burden to provide critical community health care services, such as emergent care or caring for those least able to pay, but instead are exacerbating an existing problem,” the FAH's Micklos told the panel. “However, the federation does not believe that the best way to address this deficiency is through a federal requirement that specialty hospitals maintain an emergency department.”

Both the FAH and the American Hospital Association testified that the hospitals should be required to accept appropriate transfers, however.

BALTIMORE — Hospitals with specialized capabilities should be subject to the requirements of the Emergency Medical Treatment and Labor Act even if they don't have an emergency department, a federal advisory panel on the EMTALA has recommended.

The EMTALA technical advisory group recommended that the Centers for Medicare and Medicaid Services require specialty hospitals to stabilize emergency patients and accept transfers in their specialties from other hospitals.

“We were speaking to all hospitals with specialized capabilities,” technical advisory group Chair David M. Siegel, M.D., J.D., said in an interview. Dr. Siegel is an emergency physician who serves as a consultant and clinical coordinator for Florida's Quality Improvement Organization.

In a second recommendation, the EMTALA panel voted not to require hospitals with specialized capabilities to have emergency departments.

Although not specified in the recommendation, the EMTALA requirements would apply even if specialty hospitals operate only during limited hours, Dr. Siegel said. That condition was suggested by general hospital groups.

“Many specialty hospitals have limited hours of operation, due in large part to their focus on outpatient services,” Federation of American Hospitals' Vice President and General Counsel Jeffrey Micklos told the panel. “In the best interests of serving patients, we believe that specialty hospitals should not be allowed to refuse to accept transfers on the basis that they lack capacity to treat the individuals simply because they are closed.”

While not addressing the issue of operating hours specifically, ASHA argued that there is no need to adopt any measures applying only to specialty hospitals.

“ASHA firmly believes that our members are subject to the requirements of EMTALA, as they apply to all acute care hospitals,” said ASHA representative Greg Miner. “There is no reason to write new requirements directed at specialty hospitals that merely duplicate the obligation we already have under this law.” Miner is the executive director of Siouxland Surgery Center in Dakota Dunes, S.D.

Both recommendations made by the advisory group were in response to questions posed by the Centers for Medicare and Medicaid Services.

The agency also asked whether specialty hospitals, “irrespective of whether they have emergency departments,” are subject to the EMTALA requirement that Medicare-participating hospitals “may not refuse to accept an appropriate transfer of an individual who requires such specialized capabilities or facilities if the hospital has the capacity to treat the individual.”

The recommendations were acceptable to both ASHA and general hospital representatives.

“It is clear that specialty hospitals are not shouldering their burden to provide critical community health care services, such as emergent care or caring for those least able to pay, but instead are exacerbating an existing problem,” the FAH's Micklos told the panel. “However, the federation does not believe that the best way to address this deficiency is through a federal requirement that specialty hospitals maintain an emergency department.”

Both the FAH and the American Hospital Association testified that the hospitals should be required to accept appropriate transfers, however.

BALTIMORE — Hospital emergency department on-call roster requirements should be moved from Emergency Medical Treatment and Labor Act regulations to those relating to Medicare provider agreements, a federal advisory group has recommended.

Such a move away from the regulations would ensure that plaintiffs in lawsuits could not use the requirements to file a private right of action, the recommendation's supporters said at a meeting of the Department of Health and Human Services technical advisory group on the Emergency Medical Treatment and Labor Act (EMTALA).

If on-call roster requirements remain regulated under EMTALA, “a plaintiff's lawyer could argue that the hospital has violated EMTALA—and then would have a private right of action if the plaintiff's lawyers or the plaintiff does not like the makeup of a hospital's on-call list,” said Julie Mathis Nelson, J.D., of the law firm Coopersmith Gordon Schermer Owens & Nelson in Phoenix, Ariz.

The technical advisory group makes recommendations to the Department of Health and Human Services and the administrator of the Centers for Medicare and Medicaid Services on issues related to EMTALA.

Panel member Charlotte Yeh, M.D., an emergency physician and a regional administrator with the CMS, said she was concerned that moving the requirements could eliminate patients' ability to seek compensation if injured.

But panel member Brian Robinson responded that patients could still use EMTALA to seek redress. “They could argue that they were not appropriately medically screened or not appropriately stabilized, so they still have opportunities that they can argue,” pointed out Robinson, president and CEO of HCA Las Vegas Market.

Gregory Demske, of the HHS Office of Inspector General, said the recommendation reflects the way the office approaches on-call roster violations now. “This change is consistent with the way we interpret the statute,” he said.

EMTALA regulations declare that as a requirement for participation in the Medicare program, “hospitals must maintain a list of physicians who are on call for duty after the initial examination to provide treatment necessary to stabilize an individual with an emergency medical condition,” according to CMS documents. Physician failure to respond when called could result in EMTALA violation.

CMS state operations manuals specify that each hospital has the discretion to maintain the on-call list “in a manner that best meets the needs of its patients.”

The EMTALA advisory panel is exploring possible recommendations on a number of other on-call issues. Among those under consideration: whether required physician response time to a call should be stated as a specific time or a range of minutes. The panel will also review options that fall beyond the regulatory realm of EMTALA yet could ease on-call challenges.

In testimony before the EMTALA Technical Advisory Group, the American Hospital Association said many hospitals are having difficulty maintaining full-time on-call coverage.

“From the physician's perspective, they are assuming all of the liability and bearing the costs of providing services,” testified Kathleen DeVine, CEO of Saint Anthony Hospital in Chicago.

Hospital groups said the increase of physician-owned specialty hospitals has exacerbated the on-call shortage by pulling specialists away from community hospitals. Specialty hospital representatives countered that their physician members often provide on-call services to hospitals in their area, including many community hospitals.

BALTIMORE — Hospital emergency department on-call roster requirements should be moved from Emergency Medical Treatment and Labor Act regulations to those relating to Medicare provider agreements, a federal advisory group has recommended.

Such a move away from the regulations would ensure that plaintiffs in lawsuits could not use the requirements to file a private right of action, the recommendation's supporters said at a meeting of the Department of Health and Human Services technical advisory group on the Emergency Medical Treatment and Labor Act (EMTALA).

If on-call roster requirements remain regulated under EMTALA, “a plaintiff's lawyer could argue that the hospital has violated EMTALA—and then would have a private right of action if the plaintiff's lawyers or the plaintiff does not like the makeup of a hospital's on-call list,” said Julie Mathis Nelson, J.D., of the law firm Coopersmith Gordon Schermer Owens & Nelson in Phoenix, Ariz.

The technical advisory group makes recommendations to the Department of Health and Human Services and the administrator of the Centers for Medicare and Medicaid Services on issues related to EMTALA.

Panel member Charlotte Yeh, M.D., an emergency physician and a regional administrator with the CMS, said she was concerned that moving the requirements could eliminate patients' ability to seek compensation if injured.

But panel member Brian Robinson responded that patients could still use EMTALA to seek redress. “They could argue that they were not appropriately medically screened or not appropriately stabilized, so they still have opportunities that they can argue,” pointed out Robinson, president and CEO of HCA Las Vegas Market.

Gregory Demske, of the HHS Office of Inspector General, said the recommendation reflects the way the office approaches on-call roster violations now. “This change is consistent with the way we interpret the statute,” he said.

EMTALA regulations declare that as a requirement for participation in the Medicare program, “hospitals must maintain a list of physicians who are on call for duty after the initial examination to provide treatment necessary to stabilize an individual with an emergency medical condition,” according to CMS documents. Physician failure to respond when called could result in EMTALA violation.

CMS state operations manuals specify that each hospital has the discretion to maintain the on-call list “in a manner that best meets the needs of its patients.”

The EMTALA advisory panel is exploring possible recommendations on a number of other on-call issues. Among those under consideration: whether required physician response time to a call should be stated as a specific time or a range of minutes. The panel will also review options that fall beyond the regulatory realm of EMTALA yet could ease on-call challenges.

In testimony before the EMTALA Technical Advisory Group, the American Hospital Association said many hospitals are having difficulty maintaining full-time on-call coverage.

“From the physician's perspective, they are assuming all of the liability and bearing the costs of providing services,” testified Kathleen DeVine, CEO of Saint Anthony Hospital in Chicago.

Hospital groups said the increase of physician-owned specialty hospitals has exacerbated the on-call shortage by pulling specialists away from community hospitals. Specialty hospital representatives countered that their physician members often provide on-call services to hospitals in their area, including many community hospitals.

BALTIMORE — Hospital emergency department on-call roster requirements should be moved from Emergency Medical Treatment and Labor Act regulations to those relating to Medicare provider agreements, a federal advisory group has recommended.

Such a move away from the regulations would ensure that plaintiffs in lawsuits could not use the requirements to file a private right of action, the recommendation's supporters said at a meeting of the Department of Health and Human Services technical advisory group on the Emergency Medical Treatment and Labor Act (EMTALA).

If on-call roster requirements remain regulated under EMTALA, “a plaintiff's lawyer could argue that the hospital has violated EMTALA—and then would have a private right of action if the plaintiff's lawyers or the plaintiff does not like the makeup of a hospital's on-call list,” said Julie Mathis Nelson, J.D., of the law firm Coopersmith Gordon Schermer Owens & Nelson in Phoenix, Ariz.

The technical advisory group makes recommendations to the Department of Health and Human Services and the administrator of the Centers for Medicare and Medicaid Services on issues related to EMTALA.

Panel member Charlotte Yeh, M.D., an emergency physician and a regional administrator with the CMS, said she was concerned that moving the requirements could eliminate patients' ability to seek compensation if injured.

But panel member Brian Robinson responded that patients could still use EMTALA to seek redress. “They could argue that they were not appropriately medically screened or not appropriately stabilized, so they still have opportunities that they can argue,” pointed out Robinson, president and CEO of HCA Las Vegas Market.

Gregory Demske, of the HHS Office of Inspector General, said the recommendation reflects the way the office approaches on-call roster violations now. “This change is consistent with the way we interpret the statute,” he said.

EMTALA regulations declare that as a requirement for participation in the Medicare program, “hospitals must maintain a list of physicians who are on call for duty after the initial examination to provide treatment necessary to stabilize an individual with an emergency medical condition,” according to CMS documents. Physician failure to respond when called could result in EMTALA violation.

CMS state operations manuals specify that each hospital has the discretion to maintain the on-call list “in a manner that best meets the needs of its patients.”

The EMTALA advisory panel is exploring possible recommendations on a number of other on-call issues. Among those under consideration: whether required physician response time to a call should be stated as a specific time or a range of minutes. The panel will also review options that fall beyond the regulatory realm of EMTALA yet could ease on-call challenges.

In testimony before the EMTALA Technical Advisory Group, the American Hospital Association said many hospitals are having difficulty maintaining full-time on-call coverage.

“From the physician's perspective, they are assuming all of the liability and bearing the costs of providing services,” testified Kathleen DeVine, CEO of Saint Anthony Hospital in Chicago.

Hospital groups said the increase of physician-owned specialty hospitals has exacerbated the on-call shortage by pulling specialists away from community hospitals. Specialty hospital representatives countered that their physician members often provide on-call services to hospitals in their area, including many community hospitals.

WASHINGTON — American health care could be in for the world's largest customer satisfaction survey as the U.S. Citizens' Health Care Working Group seeks comments nationwide on how to reform the system.

“In order to make health care work for all Americans, we need to hear from all Americans,” said working group member Rosario Perez, who is both a registered nurse and vice president of Mission Integration and Outreach Services for CHRISTUS Santa Rosa Health Care in San Antonio.

“We want to hear from individuals across the country. That means we want to hear your parents, your relatives, your coworkers, and people in your community.” Perez spoke at a briefing sponsored by the Citizen's Health Care Working Group.

Established by the 2003 Medicare Modernization Act, the 14-member panel will collect as many comments and suggestions as possible before April 15. Submissions will serve as the basis for panel recommendations for Congress and President Bush to consider next spring. The recommendations will address costs, care affordability, and quality improvement.

“Despite increases in medical care spending that are greater than the rate of inflation, population growth, and Gross Domestic Product growth, there has not been a commensurate improvement in our health status as a nation,” according to the law that established the working group. Among areas of interest highlighted by the working group are consumer concerns about health care delivery, benefits that should be provided, how health care should be paid for, and acceptable trade-offs to ensure broad access to services.

The group is seeking comment through its Web site (www.citizenshealthcare.gov

Sen. Orrin Hatch (R-Utah) and Sen. Ron Wyden (D-Ore.) headed this bipartisan effort.

The press briefing was held in the same Senate room as the 1912 hearings on the sinking of the Titanic, and Sen. Wyden said the U.S. health care system could suffer a similar dire fate “if something dramatic isn't done to save it.”

Sen. Wyden suggested citizen input may engender systemic change that has stymied Congress for the last 6 decades. A “citizens' road map” for change could help “overcome the feeding frenzy by special interests,” he argued.

The panel is made up of health care professionals, economists, benefits experts, and advocates from across the country, and includes Health and Human Services Secretary Michael Leavitt.

The group is chaired by Randall L. Johnson, head of corporate benefits for Motorola Inc.; vice chair is Catherine McLaughlin, Ph.D., a health economist at the University of Michigan.

To jump start the national discussion, the group developed a 30-page “Health Report to the American People,” which summarizes the current state of U.S. health care.

“Having this information prepares us as a country to ask some tough questions about whether we are getting the services we need and want, [and] whether we are getting our money's worth and choices we need and are willing to make to have health [access] for all Americans,” said Dr. McLaughlin.

She said that the working group aims to develop recommendations that would address health care as a whole.

“Our health care system is a lot like our natural environment, an ecosystem in which any significant change in one area has ripple effects throughout the others,” she said. “We need to address the entire health care system, not just specific problems like cost, quality, or access—no matter how urgent they may seem from our different perspectives.”

WASHINGTON — American health care could be in for the world's largest customer satisfaction survey as the U.S. Citizens' Health Care Working Group seeks comments nationwide on how to reform the system.

“In order to make health care work for all Americans, we need to hear from all Americans,” said working group member Rosario Perez, who is both a registered nurse and vice president of Mission Integration and Outreach Services for CHRISTUS Santa Rosa Health Care in San Antonio.

“We want to hear from individuals across the country. That means we want to hear your parents, your relatives, your coworkers, and people in your community.” Perez spoke at a briefing sponsored by the Citizen's Health Care Working Group.

Established by the 2003 Medicare Modernization Act, the 14-member panel will collect as many comments and suggestions as possible before April 15. Submissions will serve as the basis for panel recommendations for Congress and President Bush to consider next spring. The recommendations will address costs, care affordability, and quality improvement.

“Despite increases in medical care spending that are greater than the rate of inflation, population growth, and Gross Domestic Product growth, there has not been a commensurate improvement in our health status as a nation,” according to the law that established the working group. Among areas of interest highlighted by the working group are consumer concerns about health care delivery, benefits that should be provided, how health care should be paid for, and acceptable trade-offs to ensure broad access to services.

The group is seeking comment through its Web site (www.citizenshealthcare.gov

Sen. Orrin Hatch (R-Utah) and Sen. Ron Wyden (D-Ore.) headed this bipartisan effort.

The press briefing was held in the same Senate room as the 1912 hearings on the sinking of the Titanic, and Sen. Wyden said the U.S. health care system could suffer a similar dire fate “if something dramatic isn't done to save it.”

Sen. Wyden suggested citizen input may engender systemic change that has stymied Congress for the last 6 decades. A “citizens' road map” for change could help “overcome the feeding frenzy by special interests,” he argued.

The panel is made up of health care professionals, economists, benefits experts, and advocates from across the country, and includes Health and Human Services Secretary Michael Leavitt.

The group is chaired by Randall L. Johnson, head of corporate benefits for Motorola Inc.; vice chair is Catherine McLaughlin, Ph.D., a health economist at the University of Michigan.

To jump start the national discussion, the group developed a 30-page “Health Report to the American People,” which summarizes the current state of U.S. health care.

“Having this information prepares us as a country to ask some tough questions about whether we are getting the services we need and want, [and] whether we are getting our money's worth and choices we need and are willing to make to have health [access] for all Americans,” said Dr. McLaughlin.

She said that the working group aims to develop recommendations that would address health care as a whole.

“Our health care system is a lot like our natural environment, an ecosystem in which any significant change in one area has ripple effects throughout the others,” she said. “We need to address the entire health care system, not just specific problems like cost, quality, or access—no matter how urgent they may seem from our different perspectives.”

WASHINGTON — American health care could be in for the world's largest customer satisfaction survey as the U.S. Citizens' Health Care Working Group seeks comments nationwide on how to reform the system.

“In order to make health care work for all Americans, we need to hear from all Americans,” said working group member Rosario Perez, who is both a registered nurse and vice president of Mission Integration and Outreach Services for CHRISTUS Santa Rosa Health Care in San Antonio.

“We want to hear from individuals across the country. That means we want to hear your parents, your relatives, your coworkers, and people in your community.” Perez spoke at a briefing sponsored by the Citizen's Health Care Working Group.

Established by the 2003 Medicare Modernization Act, the 14-member panel will collect as many comments and suggestions as possible before April 15. Submissions will serve as the basis for panel recommendations for Congress and President Bush to consider next spring. The recommendations will address costs, care affordability, and quality improvement.

“Despite increases in medical care spending that are greater than the rate of inflation, population growth, and Gross Domestic Product growth, there has not been a commensurate improvement in our health status as a nation,” according to the law that established the working group. Among areas of interest highlighted by the working group are consumer concerns about health care delivery, benefits that should be provided, how health care should be paid for, and acceptable trade-offs to ensure broad access to services.

The group is seeking comment through its Web site (www.citizenshealthcare.gov

Sen. Orrin Hatch (R-Utah) and Sen. Ron Wyden (D-Ore.) headed this bipartisan effort.

The press briefing was held in the same Senate room as the 1912 hearings on the sinking of the Titanic, and Sen. Wyden said the U.S. health care system could suffer a similar dire fate “if something dramatic isn't done to save it.”

Sen. Wyden suggested citizen input may engender systemic change that has stymied Congress for the last 6 decades. A “citizens' road map” for change could help “overcome the feeding frenzy by special interests,” he argued.

The panel is made up of health care professionals, economists, benefits experts, and advocates from across the country, and includes Health and Human Services Secretary Michael Leavitt.

The group is chaired by Randall L. Johnson, head of corporate benefits for Motorola Inc.; vice chair is Catherine McLaughlin, Ph.D., a health economist at the University of Michigan.

To jump start the national discussion, the group developed a 30-page “Health Report to the American People,” which summarizes the current state of U.S. health care.

“Having this information prepares us as a country to ask some tough questions about whether we are getting the services we need and want, [and] whether we are getting our money's worth and choices we need and are willing to make to have health [access] for all Americans,” said Dr. McLaughlin.

She said that the working group aims to develop recommendations that would address health care as a whole.

“Our health care system is a lot like our natural environment, an ecosystem in which any significant change in one area has ripple effects throughout the others,” she said. “We need to address the entire health care system, not just specific problems like cost, quality, or access—no matter how urgent they may seem from our different perspectives.”

WASHINGTON — American health care could be in for the world's largest customer satisfaction survey as the U.S. Citizens' Health Care Working Group seeks comments nationwide on how to reform the system.

“In order to make health care work for all Americans, we need to hear from all Americans,” said working group member Rosario Perez, a registered nurse and vice president of Mission Integration and Outreach Services for CHRISTUS Santa Rosa Health Care in San Antonio. “We want to hear from individuals across the country. That means your parents, your relatives, your coworkers, and people in your community.” Perez spoke at a briefing sponsored by the Citizens' Health Care Working Group.

Established by the 2003 Medicare Modernization Act, the 14-member panel will collect as many comments and suggestions as possible before April 15. Submissions will serve as the basis for panel recommendations for Congress and President Bush to consider next spring. The recommendations will address costs, care affordability, and quality improvement.

“Despite increases in medical care spending that are greater than the rate of inflation, population growth, and Gross Domestic Product growth, there has not been a commensurate improvement in our health status as a nation,” according to the law that established the working group.

Among areas of interest highlighted by the working group are consumer concerns about health care delivery, benefits that should be provided, how health care should be paid for, and acceptable trade-offs to ensure broad access to services.

Comments will be collected via the group's Web site (www.citizenshealthcare.gov

The press briefing was held in the same Senate room as the 1912 hearings on the sinking of the Titanic, and Sen. Wyden said the U.S. health care system could suffer a similar dire fate “if something dramatic isn't done to save it.”

Sen. Wyden suggested citizen input may engender systemic change that has stymied Congress for the last 6 decades. A “citizens' road map” for change could help “overcome the feeding frenzy by special interests,” he argued.

The panel is made up of health care professionals, economists, benefits experts, and advocates from across the country, and includes Health and Human Services Secretary Michael Leavitt. The group is chaired by Randall L. Johnson, head of corporate benefits for Motorola Inc.; vice chair is Catherine McLaughlin, Ph.D., a health economist at the University of Michigan.

To jump start the discussion, the group developed a 30-page “Health Report to the American People,” which summarizes the current state of U.S. health care.

“Having this information prepares us as a country to ask some tough questions about whether we are getting the services we need and want, [and] whether we are getting our money's worth and choices we need and are willing to make to have health [access] for all Americans,” said Dr. McLaughlin.

She said that the working group aims to develop recommendations that would address health care as a whole. “Our health care system is a lot like our natural environment, an ecosystem in which any significant change in one area has ripple effects throughout the others,” she said. “We need to address the entire health care system, not just specific problems like cost, quality, or access—no matter how urgent they may seem from our different perspectives.”

WASHINGTON — American health care could be in for the world's largest customer satisfaction survey as the U.S. Citizens' Health Care Working Group seeks comments nationwide on how to reform the system.

“In order to make health care work for all Americans, we need to hear from all Americans,” said working group member Rosario Perez, a registered nurse and vice president of Mission Integration and Outreach Services for CHRISTUS Santa Rosa Health Care in San Antonio. “We want to hear from individuals across the country. That means your parents, your relatives, your coworkers, and people in your community.” Perez spoke at a briefing sponsored by the Citizens' Health Care Working Group.

Established by the 2003 Medicare Modernization Act, the 14-member panel will collect as many comments and suggestions as possible before April 15. Submissions will serve as the basis for panel recommendations for Congress and President Bush to consider next spring. The recommendations will address costs, care affordability, and quality improvement.

“Despite increases in medical care spending that are greater than the rate of inflation, population growth, and Gross Domestic Product growth, there has not been a commensurate improvement in our health status as a nation,” according to the law that established the working group.

Among areas of interest highlighted by the working group are consumer concerns about health care delivery, benefits that should be provided, how health care should be paid for, and acceptable trade-offs to ensure broad access to services.

Comments will be collected via the group's Web site (www.citizenshealthcare.gov

The press briefing was held in the same Senate room as the 1912 hearings on the sinking of the Titanic, and Sen. Wyden said the U.S. health care system could suffer a similar dire fate “if something dramatic isn't done to save it.”

Sen. Wyden suggested citizen input may engender systemic change that has stymied Congress for the last 6 decades. A “citizens' road map” for change could help “overcome the feeding frenzy by special interests,” he argued.

The panel is made up of health care professionals, economists, benefits experts, and advocates from across the country, and includes Health and Human Services Secretary Michael Leavitt. The group is chaired by Randall L. Johnson, head of corporate benefits for Motorola Inc.; vice chair is Catherine McLaughlin, Ph.D., a health economist at the University of Michigan.

To jump start the discussion, the group developed a 30-page “Health Report to the American People,” which summarizes the current state of U.S. health care.

“Having this information prepares us as a country to ask some tough questions about whether we are getting the services we need and want, [and] whether we are getting our money's worth and choices we need and are willing to make to have health [access] for all Americans,” said Dr. McLaughlin.

She said that the working group aims to develop recommendations that would address health care as a whole. “Our health care system is a lot like our natural environment, an ecosystem in which any significant change in one area has ripple effects throughout the others,” she said. “We need to address the entire health care system, not just specific problems like cost, quality, or access—no matter how urgent they may seem from our different perspectives.”

WASHINGTON — American health care could be in for the world's largest customer satisfaction survey as the U.S. Citizens' Health Care Working Group seeks comments nationwide on how to reform the system.

“In order to make health care work for all Americans, we need to hear from all Americans,” said working group member Rosario Perez, a registered nurse and vice president of Mission Integration and Outreach Services for CHRISTUS Santa Rosa Health Care in San Antonio. “We want to hear from individuals across the country. That means your parents, your relatives, your coworkers, and people in your community.” Perez spoke at a briefing sponsored by the Citizens' Health Care Working Group.

Established by the 2003 Medicare Modernization Act, the 14-member panel will collect as many comments and suggestions as possible before April 15. Submissions will serve as the basis for panel recommendations for Congress and President Bush to consider next spring. The recommendations will address costs, care affordability, and quality improvement.

“Despite increases in medical care spending that are greater than the rate of inflation, population growth, and Gross Domestic Product growth, there has not been a commensurate improvement in our health status as a nation,” according to the law that established the working group.

Among areas of interest highlighted by the working group are consumer concerns about health care delivery, benefits that should be provided, how health care should be paid for, and acceptable trade-offs to ensure broad access to services.

Comments will be collected via the group's Web site (www.citizenshealthcare.gov

The press briefing was held in the same Senate room as the 1912 hearings on the sinking of the Titanic, and Sen. Wyden said the U.S. health care system could suffer a similar dire fate “if something dramatic isn't done to save it.”

Sen. Wyden suggested citizen input may engender systemic change that has stymied Congress for the last 6 decades. A “citizens' road map” for change could help “overcome the feeding frenzy by special interests,” he argued.

The panel is made up of health care professionals, economists, benefits experts, and advocates from across the country, and includes Health and Human Services Secretary Michael Leavitt. The group is chaired by Randall L. Johnson, head of corporate benefits for Motorola Inc.; vice chair is Catherine McLaughlin, Ph.D., a health economist at the University of Michigan.

To jump start the discussion, the group developed a 30-page “Health Report to the American People,” which summarizes the current state of U.S. health care.

“Having this information prepares us as a country to ask some tough questions about whether we are getting the services we need and want, [and] whether we are getting our money's worth and choices we need and are willing to make to have health [access] for all Americans,” said Dr. McLaughlin.

She said that the working group aims to develop recommendations that would address health care as a whole. “Our health care system is a lot like our natural environment, an ecosystem in which any significant change in one area has ripple effects throughout the others,” she said. “We need to address the entire health care system, not just specific problems like cost, quality, or access—no matter how urgent they may seem from our different perspectives.”

WASHINGTON – American health care could be in for the world's largest customer satisfaction survey as the U.S. Citizens' Health Care Working Group seeks comments nationwide on how to reform the system.

“In order to make health care work for all Americans, we need to hear from all Americans,” said working group member Rosario Perez, a registered nurse and vice president of Mission Integration and Outreach Services for CHRISTUS Santa Rosa Health Care in San Antonio. “We want to hear from individuals across the country. That means your parents, your relatives, your coworkers, and people in your community.” Perez spoke at a briefing sponsored by the Citizen's Health Care Working Group.

Established by the 2003 Medicare Modernization Act, the 14-member panel will collect as many comments and suggestions as possible before April 15. Submissions will serve as the basis for panel recommendations for Congress and President Bush to consider next spring. The recommendations will address costs, care affordability, and quality improvement.

“Despite increases in medical care spending that are greater than the rate of inflation, population growth, and Gross Domestic Product growth, there has not been a commensurate improvement in our health status as a nation,” according to the law that established the working group.

Among areas of interest highlighted by the working group are consumer concerns about health care delivery, benefits that should be provided, how health care should be paid for, and acceptable trade-offs to ensure broad access to services.

Comments from the public will be collected via the group's Web site(www.citizenshealthcare.gov

The effort is the bipartisan brainchild of Sen. Orrin Hatch (R-Utah) and Sen. Ron Wyden (D-Ore.).

The press briefing was held in the same Senate room as the 1912 hearings on the sinking of the Titanic, and Sen. Wyden said the U.S. health care system could suffer a similar dire fate “if something dramatic isn't done to save it.”

Sen. Wyden suggested citizen input may engender systemic change that has stymied Congress for the last 6 decades. A “citizens' road map” for change could help “overcome the feeding frenzy by special interests,” he argued.

The panel is made up of health care professionals, economists, benefits experts, and advocates from across the country, and includes Health and Human Services Secretary Michael Leavitt. The group is chaired by Randall L. Johnson, head of corporate benefits for Motorola Inc.; vice chair is Catherine McLaughlin, Ph.D., a health economist at the University of Michigan.

To jump start the national discussion, the group developed a 30-page “Health Report to the American People,” which summarizes the current state of U.S. health care.

“Having this information prepares us as a country to ask some tough questions about whether we are getting the services we need and want, [and] whether we are getting our money's worth and choices we need and are willing to make to have health [access] for all Americans,” said Dr. McLaughlin.

She said that the working group aims to develop recommendations that would address health care as a whole. “Our health care system is a lot like our natural environment, an ecosystem in which any significant change in one area has ripple effects throughout the others,” she said. “We need to address the entire health care system, not just specific problems like cost, quality, or access–no matter how urgent they may seem from our different perspectives.”

WASHINGTON – American health care could be in for the world's largest customer satisfaction survey as the U.S. Citizens' Health Care Working Group seeks comments nationwide on how to reform the system.

“In order to make health care work for all Americans, we need to hear from all Americans,” said working group member Rosario Perez, a registered nurse and vice president of Mission Integration and Outreach Services for CHRISTUS Santa Rosa Health Care in San Antonio. “We want to hear from individuals across the country. That means your parents, your relatives, your coworkers, and people in your community.” Perez spoke at a briefing sponsored by the Citizen's Health Care Working Group.

Established by the 2003 Medicare Modernization Act, the 14-member panel will collect as many comments and suggestions as possible before April 15. Submissions will serve as the basis for panel recommendations for Congress and President Bush to consider next spring. The recommendations will address costs, care affordability, and quality improvement.

“Despite increases in medical care spending that are greater than the rate of inflation, population growth, and Gross Domestic Product growth, there has not been a commensurate improvement in our health status as a nation,” according to the law that established the working group.

Among areas of interest highlighted by the working group are consumer concerns about health care delivery, benefits that should be provided, how health care should be paid for, and acceptable trade-offs to ensure broad access to services.

Comments from the public will be collected via the group's Web site(www.citizenshealthcare.gov

The effort is the bipartisan brainchild of Sen. Orrin Hatch (R-Utah) and Sen. Ron Wyden (D-Ore.).

The press briefing was held in the same Senate room as the 1912 hearings on the sinking of the Titanic, and Sen. Wyden said the U.S. health care system could suffer a similar dire fate “if something dramatic isn't done to save it.”

Sen. Wyden suggested citizen input may engender systemic change that has stymied Congress for the last 6 decades. A “citizens' road map” for change could help “overcome the feeding frenzy by special interests,” he argued.

The panel is made up of health care professionals, economists, benefits experts, and advocates from across the country, and includes Health and Human Services Secretary Michael Leavitt. The group is chaired by Randall L. Johnson, head of corporate benefits for Motorola Inc.; vice chair is Catherine McLaughlin, Ph.D., a health economist at the University of Michigan.

To jump start the national discussion, the group developed a 30-page “Health Report to the American People,” which summarizes the current state of U.S. health care.

“Having this information prepares us as a country to ask some tough questions about whether we are getting the services we need and want, [and] whether we are getting our money's worth and choices we need and are willing to make to have health [access] for all Americans,” said Dr. McLaughlin.

She said that the working group aims to develop recommendations that would address health care as a whole. “Our health care system is a lot like our natural environment, an ecosystem in which any significant change in one area has ripple effects throughout the others,” she said. “We need to address the entire health care system, not just specific problems like cost, quality, or access–no matter how urgent they may seem from our different perspectives.”

WASHINGTON – American health care could be in for the world's largest customer satisfaction survey as the U.S. Citizens' Health Care Working Group seeks comments nationwide on how to reform the system.

“In order to make health care work for all Americans, we need to hear from all Americans,” said working group member Rosario Perez, a registered nurse and vice president of Mission Integration and Outreach Services for CHRISTUS Santa Rosa Health Care in San Antonio. “We want to hear from individuals across the country. That means your parents, your relatives, your coworkers, and people in your community.” Perez spoke at a briefing sponsored by the Citizen's Health Care Working Group.

Established by the 2003 Medicare Modernization Act, the 14-member panel will collect as many comments and suggestions as possible before April 15. Submissions will serve as the basis for panel recommendations for Congress and President Bush to consider next spring. The recommendations will address costs, care affordability, and quality improvement.

“Despite increases in medical care spending that are greater than the rate of inflation, population growth, and Gross Domestic Product growth, there has not been a commensurate improvement in our health status as a nation,” according to the law that established the working group.

Among areas of interest highlighted by the working group are consumer concerns about health care delivery, benefits that should be provided, how health care should be paid for, and acceptable trade-offs to ensure broad access to services.

Comments from the public will be collected via the group's Web site(www.citizenshealthcare.gov

The effort is the bipartisan brainchild of Sen. Orrin Hatch (R-Utah) and Sen. Ron Wyden (D-Ore.).

The press briefing was held in the same Senate room as the 1912 hearings on the sinking of the Titanic, and Sen. Wyden said the U.S. health care system could suffer a similar dire fate “if something dramatic isn't done to save it.”

Sen. Wyden suggested citizen input may engender systemic change that has stymied Congress for the last 6 decades. A “citizens' road map” for change could help “overcome the feeding frenzy by special interests,” he argued.

The panel is made up of health care professionals, economists, benefits experts, and advocates from across the country, and includes Health and Human Services Secretary Michael Leavitt. The group is chaired by Randall L. Johnson, head of corporate benefits for Motorola Inc.; vice chair is Catherine McLaughlin, Ph.D., a health economist at the University of Michigan.

To jump start the national discussion, the group developed a 30-page “Health Report to the American People,” which summarizes the current state of U.S. health care.

“Having this information prepares us as a country to ask some tough questions about whether we are getting the services we need and want, [and] whether we are getting our money's worth and choices we need and are willing to make to have health [access] for all Americans,” said Dr. McLaughlin.

She said that the working group aims to develop recommendations that would address health care as a whole. “Our health care system is a lot like our natural environment, an ecosystem in which any significant change in one area has ripple effects throughout the others,” she said. “We need to address the entire health care system, not just specific problems like cost, quality, or access–no matter how urgent they may seem from our different perspectives.”

WASHINGTON — American health care could be in for the world's largest customer satisfaction survey as the U.S. Citizens' Health Care Working Group seeks comments nationwide on how to reform the system.

"In order to make health care work for all Americans, we need to hear from all Americans," said working group member Rosario Perez, a registered nurse and vice president of Mission Integration and Outreach Services for CHRISTUS Santa Rosa Health Care in San Antonio.

"We want to hear from individuals across the country. That means your parents, your relatives, your coworkers, and people in your community," said Perez. She was speaking at a briefing sponsored by the Citizen's Health Care Working Group.

The 14-member panel, which was established by the 2003 Medicare Modernization Act, will collect as many comments and suggestions as possible before April 15.

Submissions will serve as the basis for panel recommendations for Congress and President Bush to consider next spring. The recommendations will address costs, care affordability, and quality improvement.

"Despite increases in medical care spending that are greater than the rate of inflation, population growth, and Gross Domestic Product growth, there has not been a commensurate improvement in our health status as a nation," according to the law that established the working group.

Among areas of interest highlighted by the working group are consumer concerns about health care delivery, benefits that should be provided, how health care should be paid for, and acceptable trade-offs to ensure broad access to services.

Comments will be collected through "town hall"-style community meetings planned for every state and on the group's Web site (www.citizenshealthcare.gov

The effort is the bipartisan brainchild of Sen. Orrin Hatch (R-Utah) and Sen. Ron Wyden (D-Ore.).

The press briefing was held in the same Senate room as the 1912 hearings on the sinking of the Titanic, and Sen. Wyden said the U.S. health care system could suffer a similar dire fate "if something dramatic isn't done to save it."

Sen. Wyden suggested that citizen input may engender systemic change that has stymied Congress for the last 6 decades. A "citizens' road map" for change could help "overcome the feeding frenzy by special interests," he argued.

The panel is made up of health care professionals, economists, benefits experts, and advocates from across the country, and includes Health and Human Services Secretary Michael Leavitt.

The group is chaired by Randall L. Johnson, head of corporate benefits for Motorola Inc.; vice chair is Catherine McLaughlin, Ph.D., a health economist at the University of Michigan.

To jump start the national discussion, the group developed a 30-page "Health Report to the American People," which summarizes the current state of U.S. health care.

"Having this information prepares us as a country to ask some tough questions about whether we are getting the services we need and want, [and] whether we are getting our money's worth and choices we need and are willing to make to have health [access] for all Americans," said Dr. McLaughlin.

She said that the working group aims to develop recommendations that would address health care as a whole.

"Our health care system is a lot like our natural environment, an ecosystem in which any significant change in one area has ripple effects throughout the others," she said.

"We need to address the entire health care system, not just specific problems like cost, quality, or access—no matter how urgent they may seem from our different perspectives," Dr. McLaughlin said.

WASHINGTON — American health care could be in for the world's largest customer satisfaction survey as the U.S. Citizens' Health Care Working Group seeks comments nationwide on how to reform the system.

"In order to make health care work for all Americans, we need to hear from all Americans," said working group member Rosario Perez, a registered nurse and vice president of Mission Integration and Outreach Services for CHRISTUS Santa Rosa Health Care in San Antonio.

"We want to hear from individuals across the country. That means your parents, your relatives, your coworkers, and people in your community," said Perez. She was speaking at a briefing sponsored by the Citizen's Health Care Working Group.

The 14-member panel, which was established by the 2003 Medicare Modernization Act, will collect as many comments and suggestions as possible before April 15.

Submissions will serve as the basis for panel recommendations for Congress and President Bush to consider next spring. The recommendations will address costs, care affordability, and quality improvement.

"Despite increases in medical care spending that are greater than the rate of inflation, population growth, and Gross Domestic Product growth, there has not been a commensurate improvement in our health status as a nation," according to the law that established the working group.

Among areas of interest highlighted by the working group are consumer concerns about health care delivery, benefits that should be provided, how health care should be paid for, and acceptable trade-offs to ensure broad access to services.

Comments will be collected through "town hall"-style community meetings planned for every state and on the group's Web site (www.citizenshealthcare.gov

The effort is the bipartisan brainchild of Sen. Orrin Hatch (R-Utah) and Sen. Ron Wyden (D-Ore.).

The press briefing was held in the same Senate room as the 1912 hearings on the sinking of the Titanic, and Sen. Wyden said the U.S. health care system could suffer a similar dire fate "if something dramatic isn't done to save it."

Sen. Wyden suggested that citizen input may engender systemic change that has stymied Congress for the last 6 decades. A "citizens' road map" for change could help "overcome the feeding frenzy by special interests," he argued.

The panel is made up of health care professionals, economists, benefits experts, and advocates from across the country, and includes Health and Human Services Secretary Michael Leavitt.

The group is chaired by Randall L. Johnson, head of corporate benefits for Motorola Inc.; vice chair is Catherine McLaughlin, Ph.D., a health economist at the University of Michigan.

To jump start the national discussion, the group developed a 30-page "Health Report to the American People," which summarizes the current state of U.S. health care.

"Having this information prepares us as a country to ask some tough questions about whether we are getting the services we need and want, [and] whether we are getting our money's worth and choices we need and are willing to make to have health [access] for all Americans," said Dr. McLaughlin.

She said that the working group aims to develop recommendations that would address health care as a whole.

"Our health care system is a lot like our natural environment, an ecosystem in which any significant change in one area has ripple effects throughout the others," she said.

"We need to address the entire health care system, not just specific problems like cost, quality, or access—no matter how urgent they may seem from our different perspectives," Dr. McLaughlin said.

WASHINGTON — American health care could be in for the world's largest customer satisfaction survey as the U.S. Citizens' Health Care Working Group seeks comments nationwide on how to reform the system.

"In order to make health care work for all Americans, we need to hear from all Americans," said working group member Rosario Perez, a registered nurse and vice president of Mission Integration and Outreach Services for CHRISTUS Santa Rosa Health Care in San Antonio.

"We want to hear from individuals across the country. That means your parents, your relatives, your coworkers, and people in your community," said Perez. She was speaking at a briefing sponsored by the Citizen's Health Care Working Group.

The 14-member panel, which was established by the 2003 Medicare Modernization Act, will collect as many comments and suggestions as possible before April 15.

Submissions will serve as the basis for panel recommendations for Congress and President Bush to consider next spring. The recommendations will address costs, care affordability, and quality improvement.

"Despite increases in medical care spending that are greater than the rate of inflation, population growth, and Gross Domestic Product growth, there has not been a commensurate improvement in our health status as a nation," according to the law that established the working group.

Among areas of interest highlighted by the working group are consumer concerns about health care delivery, benefits that should be provided, how health care should be paid for, and acceptable trade-offs to ensure broad access to services.

Comments will be collected through "town hall"-style community meetings planned for every state and on the group's Web site (www.citizenshealthcare.gov

The effort is the bipartisan brainchild of Sen. Orrin Hatch (R-Utah) and Sen. Ron Wyden (D-Ore.).

The press briefing was held in the same Senate room as the 1912 hearings on the sinking of the Titanic, and Sen. Wyden said the U.S. health care system could suffer a similar dire fate "if something dramatic isn't done to save it."

Sen. Wyden suggested that citizen input may engender systemic change that has stymied Congress for the last 6 decades. A "citizens' road map" for change could help "overcome the feeding frenzy by special interests," he argued.

The panel is made up of health care professionals, economists, benefits experts, and advocates from across the country, and includes Health and Human Services Secretary Michael Leavitt.

The group is chaired by Randall L. Johnson, head of corporate benefits for Motorola Inc.; vice chair is Catherine McLaughlin, Ph.D., a health economist at the University of Michigan.

To jump start the national discussion, the group developed a 30-page "Health Report to the American People," which summarizes the current state of U.S. health care.

"Having this information prepares us as a country to ask some tough questions about whether we are getting the services we need and want, [and] whether we are getting our money's worth and choices we need and are willing to make to have health [access] for all Americans," said Dr. McLaughlin.

She said that the working group aims to develop recommendations that would address health care as a whole.

"Our health care system is a lot like our natural environment, an ecosystem in which any significant change in one area has ripple effects throughout the others," she said.

"We need to address the entire health care system, not just specific problems like cost, quality, or access—no matter how urgent they may seem from our different perspectives," Dr. McLaughlin said.

WASHINGTON — American health care could be in for the world's largest customer satisfaction survey as the U.S. Citizens' Health Care Working Group seeks comments nationwide on how to reform the system.

“In order to make health care work for all Americans, we need to hear from all Americans,” said working group member Rosario Perez, a registered nurse and vice president of Mission Integration and Outreach Services for CHRISTUS Santa Rosa Health Care in San Antonio.

“We want to hear from individuals across the country. That means your parents, your relatives, your coworkers, and people in your community,” she said. Perez spoke at a briefing sponsored by the Citizen's Health Care Working Group.

Established by the 2003 Medicare Modernization Act, the 14-member panel will collect as many comments and suggestions as possible before April 15.

Submissions will serve as the basis for panel recommendations for Congress and President Bush to consider next spring. The recommendations will address costs, care affordability, and quality improvement.

“Despite increases in medical care spending that are greater than the rate of inflation, population growth, and Gross Domestic Product growth, there has not been a commensurate improvement in our health status as a nation,” according to the law that established the working group.

Among areas of interest highlighted by the working group are consumer concerns about health care delivery, benefits that should be provided, how health care should be paid for, and acceptable trade-offs to ensure broad access to health care services.

Comments will be collected via the group's Web site (www.citizenshealthcare.gov

The effort is the bipartisan brainchild of Sen. Orrin Hatch (R-Utah) and Sen. Ron Wyden (D-Ore.).

The press briefing was held in the same Senate room as the 1912 hearings on the sinking of the Titanic, and Sen. Wyden said the U.S. health care system could suffer a similar dire fate “if something dramatic isn't done to save it.”

Sen. Wyden suggested citizen input may engender systemic change that has stymied Congress for the last 6 decades.

A “citizens' road map” for change could help “overcome the feeding frenzy by special interests,” he argued.

The panel is made up of health care professionals, economists, benefits experts, and advocates from across the country, and includes Health and Human Services Secretary Michael Leavitt.

The group is chaired by Randall L. Johnson, head of corporate benefits for Motorola Inc.; vice chair is Catherine McLaughlin, Ph.D., a health economist at the University of Michigan.

To jump start the national discussion, the group developed a 30-page “Health Report to the American People,” which summarizes the current state of U.S. health care.

“Having this information prepares us as a country to ask some tough questions about whether we are getting the services we need and want, [and] whether we are getting our money's worth and choices we need and are willing to make to have health [access] for all Americans,” said Dr. McLaughlin.

She said that the working group aims to develop recommendations that would address health care as a whole.

“Our health care system is a lot like our natural environment, an ecosystem in which any significant change in one area has ripple effects throughout the others,” she said.

“We need to address the entire health care system, not just specific problems like cost, quality, or access—no matter how urgent they may seem from our different perspectives,” Ms. Perez said.

WASHINGTON — American health care could be in for the world's largest customer satisfaction survey as the U.S. Citizens' Health Care Working Group seeks comments nationwide on how to reform the system.

“In order to make health care work for all Americans, we need to hear from all Americans,” said working group member Rosario Perez, a registered nurse and vice president of Mission Integration and Outreach Services for CHRISTUS Santa Rosa Health Care in San Antonio.

“We want to hear from individuals across the country. That means your parents, your relatives, your coworkers, and people in your community,” she said. Perez spoke at a briefing sponsored by the Citizen's Health Care Working Group.

Established by the 2003 Medicare Modernization Act, the 14-member panel will collect as many comments and suggestions as possible before April 15.

Submissions will serve as the basis for panel recommendations for Congress and President Bush to consider next spring. The recommendations will address costs, care affordability, and quality improvement.

“Despite increases in medical care spending that are greater than the rate of inflation, population growth, and Gross Domestic Product growth, there has not been a commensurate improvement in our health status as a nation,” according to the law that established the working group.

Among areas of interest highlighted by the working group are consumer concerns about health care delivery, benefits that should be provided, how health care should be paid for, and acceptable trade-offs to ensure broad access to health care services.

Comments will be collected via the group's Web site (www.citizenshealthcare.gov

The effort is the bipartisan brainchild of Sen. Orrin Hatch (R-Utah) and Sen. Ron Wyden (D-Ore.).

The press briefing was held in the same Senate room as the 1912 hearings on the sinking of the Titanic, and Sen. Wyden said the U.S. health care system could suffer a similar dire fate “if something dramatic isn't done to save it.”

Sen. Wyden suggested citizen input may engender systemic change that has stymied Congress for the last 6 decades.

A “citizens' road map” for change could help “overcome the feeding frenzy by special interests,” he argued.

The panel is made up of health care professionals, economists, benefits experts, and advocates from across the country, and includes Health and Human Services Secretary Michael Leavitt.

The group is chaired by Randall L. Johnson, head of corporate benefits for Motorola Inc.; vice chair is Catherine McLaughlin, Ph.D., a health economist at the University of Michigan.

To jump start the national discussion, the group developed a 30-page “Health Report to the American People,” which summarizes the current state of U.S. health care.

“Having this information prepares us as a country to ask some tough questions about whether we are getting the services we need and want, [and] whether we are getting our money's worth and choices we need and are willing to make to have health [access] for all Americans,” said Dr. McLaughlin.

She said that the working group aims to develop recommendations that would address health care as a whole.

“Our health care system is a lot like our natural environment, an ecosystem in which any significant change in one area has ripple effects throughout the others,” she said.

“We need to address the entire health care system, not just specific problems like cost, quality, or access—no matter how urgent they may seem from our different perspectives,” Ms. Perez said.

WASHINGTON — American health care could be in for the world's largest customer satisfaction survey as the U.S. Citizens' Health Care Working Group seeks comments nationwide on how to reform the system.

“In order to make health care work for all Americans, we need to hear from all Americans,” said working group member Rosario Perez, a registered nurse and vice president of Mission Integration and Outreach Services for CHRISTUS Santa Rosa Health Care in San Antonio.

“We want to hear from individuals across the country. That means your parents, your relatives, your coworkers, and people in your community,” she said. Perez spoke at a briefing sponsored by the Citizen's Health Care Working Group.

Established by the 2003 Medicare Modernization Act, the 14-member panel will collect as many comments and suggestions as possible before April 15.

Submissions will serve as the basis for panel recommendations for Congress and President Bush to consider next spring. The recommendations will address costs, care affordability, and quality improvement.

“Despite increases in medical care spending that are greater than the rate of inflation, population growth, and Gross Domestic Product growth, there has not been a commensurate improvement in our health status as a nation,” according to the law that established the working group.

Among areas of interest highlighted by the working group are consumer concerns about health care delivery, benefits that should be provided, how health care should be paid for, and acceptable trade-offs to ensure broad access to health care services.

Comments will be collected via the group's Web site (www.citizenshealthcare.gov

The effort is the bipartisan brainchild of Sen. Orrin Hatch (R-Utah) and Sen. Ron Wyden (D-Ore.).

The press briefing was held in the same Senate room as the 1912 hearings on the sinking of the Titanic, and Sen. Wyden said the U.S. health care system could suffer a similar dire fate “if something dramatic isn't done to save it.”

Sen. Wyden suggested citizen input may engender systemic change that has stymied Congress for the last 6 decades.

A “citizens' road map” for change could help “overcome the feeding frenzy by special interests,” he argued.

The panel is made up of health care professionals, economists, benefits experts, and advocates from across the country, and includes Health and Human Services Secretary Michael Leavitt.

The group is chaired by Randall L. Johnson, head of corporate benefits for Motorola Inc.; vice chair is Catherine McLaughlin, Ph.D., a health economist at the University of Michigan.

To jump start the national discussion, the group developed a 30-page “Health Report to the American People,” which summarizes the current state of U.S. health care.

“Having this information prepares us as a country to ask some tough questions about whether we are getting the services we need and want, [and] whether we are getting our money's worth and choices we need and are willing to make to have health [access] for all Americans,” said Dr. McLaughlin.

She said that the working group aims to develop recommendations that would address health care as a whole.

“Our health care system is a lot like our natural environment, an ecosystem in which any significant change in one area has ripple effects throughout the others,” she said.

“We need to address the entire health care system, not just specific problems like cost, quality, or access—no matter how urgent they may seem from our different perspectives,” Ms. Perez said.

WASHINGTON — A coalition of national mental health organizations—including the American Psychiatric Association and the National Alliance for the Mentally Ill—has launched a campaign aimed at implementing some of the goals set 2 years ago by the New Freedom Commission on Mental Health.

A top priority of the effort, called the Campaign for Mental Health Reform, is the enactment of mental health-parity legislation.

Other priorities include using Medicaid funds for home- and community-based care instead of institutional services and allowing states to fund comprehensive treatment plans. The campaign also will work for legislation aimed at allowing families to buy into Medicaid services for children with disabilities.

Ending discrimination in the treatment of mental illness is “the next frontier,” according to Sen. Edward M. Kennedy (D-Mass.), who attended the press event in late July outlining the campaign's agenda.

“It is something that this country has to come to grips with. [We] should and will be the better country, be a fairer, more just country, when we deal with this in the way that we have with physical illness,” said Sen. Kennedy, who was joined by several other members of Congress, including Sen. Mike DeWine (R-Ohio), Rep. Patrick Kennedy (D-R.I.), Rep. Sue Myrick (R-N.C.), and Rep. Jim Ramstad (R-Minn).

The coalition's steering committee members are from the Bazelon Center for Mental Health Law, the National Association of State Mental Health Program Directors, the National Mental Health Association, and NAMI. The group developed “Emergency Response: A Roadmap for Federal Action on America's Mental Health Crisis,” which lists 28 “action steps” aimed at improving provision of mental health services in the United States.

In 2003, President Bush's New Freedom Commission on Mental Health report called for “fundamental transformation of the nation's approach to mental health care.” However, the Campaign for Mental Health Reform noted in its executive summary that “there has been little progress in realizing the commission's goals or implementing its recommendations.”

In fact, since the commission released its report, the campaign noted, 63,000 Americans have died from suicide; more than 200,000 Americans with mental illness have been incarcerated; more than 25,000 families have given up custody of their children to get them mental health services; and juvenile detention centers have spent $200 million “warehousing” youth instead of providing treatment.

The campaign estimates that the U.S. economy has lost more than $150 billion in productivity because of unaddressed mental health needs.

Other priorities for the group include reforming copayments for mental health treatment under Medicare and providing early identification and effective treatment both for returning veterans at risk of posttraumatic stress disorder and to mothers and children who receive health care at federally funded maternal and child health clinics.

The coalition also advocates presumptive eligibility for Social Security benefits and Medicaid for mentally ill homeless people and diverting mentally ill individuals who have committed nonviolent crimes into treatment instead of jail or prison.

Some of the group's priority proposals are included in legislation pending in the House or Senate, campaign director Charles Konigsberg said. For example, mental health parity is outlined in the Paul Wellstone Mental Health Equitable Treatment Act of 2005, sponsored in the House by Rep. Kennedy. Attempts to pass mental health-parity legislation have failed for the last several years.

Legislation to encourage states to let parents keep custody of their mentally ill children and still receive services is sponsored in the House by Rep. Ramstad and in the Senate by Sen. Susan Collins (R-Maine).

Mr. Konigsberg said the campaign considers its effort complementary to that of a federal agency agenda for mental health services improvement announced a few days earlier by six federal departments. The “multiyear effort to alter the form and function of the mental health system,” includes a federal executive steering committee that would oversee the “mental health system transformation,” according to press materials.

The 70-item Mental Health Action Agenda includes reinforcing the message that mental illness and emotional disturbances are treatable and that “recovery is the expectation,” through a national public education program sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA).

The agenda also proposes working to reduce the number of suicides through implementation of the National Strategy for Suicide Prevention and helping states formulate and implement comprehensive state mental health plans that would be able to create individualized plans of care.

The federal effort's steering committee includes 13 members from the Department of Health and Human Services and one representative from each of the departments of Agriculture, Housing and Urban Development, Veterans Affairs, Education, Justice, and Transportation, as well as a member from the Social Security Administration.

WASHINGTON — A coalition of national mental health organizations—including the American Psychiatric Association and the National Alliance for the Mentally Ill—has launched a campaign aimed at implementing some of the goals set 2 years ago by the New Freedom Commission on Mental Health.

A top priority of the effort, called the Campaign for Mental Health Reform, is the enactment of mental health-parity legislation.

Other priorities include using Medicaid funds for home- and community-based care instead of institutional services and allowing states to fund comprehensive treatment plans. The campaign also will work for legislation aimed at allowing families to buy into Medicaid services for children with disabilities.

Ending discrimination in the treatment of mental illness is “the next frontier,” according to Sen. Edward M. Kennedy (D-Mass.), who attended the press event in late July outlining the campaign's agenda.

“It is something that this country has to come to grips with. [We] should and will be the better country, be a fairer, more just country, when we deal with this in the way that we have with physical illness,” said Sen. Kennedy, who was joined by several other members of Congress, including Sen. Mike DeWine (R-Ohio), Rep. Patrick Kennedy (D-R.I.), Rep. Sue Myrick (R-N.C.), and Rep. Jim Ramstad (R-Minn).

The coalition's steering committee members are from the Bazelon Center for Mental Health Law, the National Association of State Mental Health Program Directors, the National Mental Health Association, and NAMI. The group developed “Emergency Response: A Roadmap for Federal Action on America's Mental Health Crisis,” which lists 28 “action steps” aimed at improving provision of mental health services in the United States.

In 2003, President Bush's New Freedom Commission on Mental Health report called for “fundamental transformation of the nation's approach to mental health care.” However, the Campaign for Mental Health Reform noted in its executive summary that “there has been little progress in realizing the commission's goals or implementing its recommendations.”

In fact, since the commission released its report, the campaign noted, 63,000 Americans have died from suicide; more than 200,000 Americans with mental illness have been incarcerated; more than 25,000 families have given up custody of their children to get them mental health services; and juvenile detention centers have spent $200 million “warehousing” youth instead of providing treatment.

The campaign estimates that the U.S. economy has lost more than $150 billion in productivity because of unaddressed mental health needs.

Other priorities for the group include reforming copayments for mental health treatment under Medicare and providing early identification and effective treatment both for returning veterans at risk of posttraumatic stress disorder and to mothers and children who receive health care at federally funded maternal and child health clinics.

The coalition also advocates presumptive eligibility for Social Security benefits and Medicaid for mentally ill homeless people and diverting mentally ill individuals who have committed nonviolent crimes into treatment instead of jail or prison.

Some of the group's priority proposals are included in legislation pending in the House or Senate, campaign director Charles Konigsberg said. For example, mental health parity is outlined in the Paul Wellstone Mental Health Equitable Treatment Act of 2005, sponsored in the House by Rep. Kennedy. Attempts to pass mental health-parity legislation have failed for the last several years.

Legislation to encourage states to let parents keep custody of their mentally ill children and still receive services is sponsored in the House by Rep. Ramstad and in the Senate by Sen. Susan Collins (R-Maine).

Mr. Konigsberg said the campaign considers its effort complementary to that of a federal agency agenda for mental health services improvement announced a few days earlier by six federal departments. The “multiyear effort to alter the form and function of the mental health system,” includes a federal executive steering committee that would oversee the “mental health system transformation,” according to press materials.

The 70-item Mental Health Action Agenda includes reinforcing the message that mental illness and emotional disturbances are treatable and that “recovery is the expectation,” through a national public education program sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA).

The agenda also proposes working to reduce the number of suicides through implementation of the National Strategy for Suicide Prevention and helping states formulate and implement comprehensive state mental health plans that would be able to create individualized plans of care.

The federal effort's steering committee includes 13 members from the Department of Health and Human Services and one representative from each of the departments of Agriculture, Housing and Urban Development, Veterans Affairs, Education, Justice, and Transportation, as well as a member from the Social Security Administration.

WASHINGTON — A coalition of national mental health organizations—including the American Psychiatric Association and the National Alliance for the Mentally Ill—has launched a campaign aimed at implementing some of the goals set 2 years ago by the New Freedom Commission on Mental Health.

A top priority of the effort, called the Campaign for Mental Health Reform, is the enactment of mental health-parity legislation.

Other priorities include using Medicaid funds for home- and community-based care instead of institutional services and allowing states to fund comprehensive treatment plans. The campaign also will work for legislation aimed at allowing families to buy into Medicaid services for children with disabilities.

Ending discrimination in the treatment of mental illness is “the next frontier,” according to Sen. Edward M. Kennedy (D-Mass.), who attended the press event in late July outlining the campaign's agenda.

“It is something that this country has to come to grips with. [We] should and will be the better country, be a fairer, more just country, when we deal with this in the way that we have with physical illness,” said Sen. Kennedy, who was joined by several other members of Congress, including Sen. Mike DeWine (R-Ohio), Rep. Patrick Kennedy (D-R.I.), Rep. Sue Myrick (R-N.C.), and Rep. Jim Ramstad (R-Minn).

The coalition's steering committee members are from the Bazelon Center for Mental Health Law, the National Association of State Mental Health Program Directors, the National Mental Health Association, and NAMI. The group developed “Emergency Response: A Roadmap for Federal Action on America's Mental Health Crisis,” which lists 28 “action steps” aimed at improving provision of mental health services in the United States.

In 2003, President Bush's New Freedom Commission on Mental Health report called for “fundamental transformation of the nation's approach to mental health care.” However, the Campaign for Mental Health Reform noted in its executive summary that “there has been little progress in realizing the commission's goals or implementing its recommendations.”

In fact, since the commission released its report, the campaign noted, 63,000 Americans have died from suicide; more than 200,000 Americans with mental illness have been incarcerated; more than 25,000 families have given up custody of their children to get them mental health services; and juvenile detention centers have spent $200 million “warehousing” youth instead of providing treatment.

The campaign estimates that the U.S. economy has lost more than $150 billion in productivity because of unaddressed mental health needs.

Other priorities for the group include reforming copayments for mental health treatment under Medicare and providing early identification and effective treatment both for returning veterans at risk of posttraumatic stress disorder and to mothers and children who receive health care at federally funded maternal and child health clinics.

The coalition also advocates presumptive eligibility for Social Security benefits and Medicaid for mentally ill homeless people and diverting mentally ill individuals who have committed nonviolent crimes into treatment instead of jail or prison.

Some of the group's priority proposals are included in legislation pending in the House or Senate, campaign director Charles Konigsberg said. For example, mental health parity is outlined in the Paul Wellstone Mental Health Equitable Treatment Act of 2005, sponsored in the House by Rep. Kennedy. Attempts to pass mental health-parity legislation have failed for the last several years.

Legislation to encourage states to let parents keep custody of their mentally ill children and still receive services is sponsored in the House by Rep. Ramstad and in the Senate by Sen. Susan Collins (R-Maine).

Mr. Konigsberg said the campaign considers its effort complementary to that of a federal agency agenda for mental health services improvement announced a few days earlier by six federal departments. The “multiyear effort to alter the form and function of the mental health system,” includes a federal executive steering committee that would oversee the “mental health system transformation,” according to press materials.

The 70-item Mental Health Action Agenda includes reinforcing the message that mental illness and emotional disturbances are treatable and that “recovery is the expectation,” through a national public education program sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA).

The agenda also proposes working to reduce the number of suicides through implementation of the National Strategy for Suicide Prevention and helping states formulate and implement comprehensive state mental health plans that would be able to create individualized plans of care.

The federal effort's steering committee includes 13 members from the Department of Health and Human Services and one representative from each of the departments of Agriculture, Housing and Urban Development, Veterans Affairs, Education, Justice, and Transportation, as well as a member from the Social Security Administration.

From safety concerns to the problem of well-meaning but excess emergency personnel, lessons are emerging in Hurricane Katrina's aftermath that should reshape how emergency medicine and disaster management systems respond to future catastrophes.

Planners have focused on contingencies if parts of cities or some streets and services were disrupted by a disaster for a number of blocks—but not when all services, health facilities, and communications were obliterated in an area the size of Great Britain—as occurred with Katrina—said ACEP Public Health Committee Chair Jon Mark Hirshon, M.D.

“One of the things I think people need to realize is that we've been planning for disasters for years, but [Katrina] is by definition a catastrophe,” Dr. Hirshon said.

Although emergency medicine leaders said the profession responded admirably to the Katrina crisis, the overall chaotic nature of Gulf Coast rescue operations leaves many areas for study through emergency plan reviews and academic research.

Safety First

The need to focus on safety was a primary lesson inflicted by Katrina.

Medical personnel should have been more alert to potentially violent situations and planned accordingly, said ACEP Disaster Medicine Section Chair Eric Weinstein, M.D. “If you work in a daily environment—fire, rescue, EMS—with gunfire, then you have to assume it's going to be there in a disaster,” he argued.

Responders “didn't think it through. They figured that these people were helpless and wanted help, which was true, but they also then realized that there were hungry people out there with guns—plus there were bad guys out there looking to seize upon the situation,” he explained.

Medical personnel should coordinate with security organizations during disasters to make sure they are accompanied by adequate protection, Dr. Weinstein said.

Dr. Hirshon agreed, saying that violence toward responders not only threatens individuals but also costs rescue operations. “It is unwise to put yourself in harm's way, because you could end up being a casualty and becoming a burden on the system,” he said.

Protection should be required of hospitals as well, which were reportedly faced with armed looters in the hurricane's aftermath. Dr. Weinstein suggested that hospitals have “hired gunmen” who can protect patients and hospital supplies.

Physicians should take a lead role in determining the evacuation abilities of vulnerable individuals, another major problem in New Orleans, Dr. Weinstein added. “I think that the medical community let down, because I think [it] should be more attuned to the patient's ability to evacuate,” he said.

“Health care providers can do a better job. They teach people how to eat, they teach people not to smoke and to have healthy lifestyles; let's talk about how [each patient] is going to evacuate,” he suggested.

If patients do not have the resources to get themselves out, he said, physicians should ask if patients object to them notifying a public agency that could coordinate transportation for the patient during an emergency. The agency should be alerted to patient medications and any other special needs.

Red-Tape Tangles

Bureaucratic steps involved in medical personnel deployment need to be reviewed, Dr. Hirshon said, including the possibility of portable credentials that can apply to multiple jurisdictions in emergencies.

He also suggested strengthening the response command and control structure, which he said “was fragmented initially.” Knowing who is in charge when multiple jurisdictions respond is something that needs to be worked out beforehand, he said.

Disaster response planning has always assumed the local jurisdiction would respond first, followed by states, and then the federal government, “which may take as long as 3–4 days,” noted Andrew I. Bern, M.D., past chair of ACEP's Disaster Medicine section. That process needs to be reviewed, he said, in light of the hurricane's devastating effects.

“The federal government doesn't have the precedent, up until now, where the expectation was that they would immediately take over the management, coordination, and running of the entire event,” Dr. Bern explained.

Another area of concern, experts said, is excess personnel.

When volunteers show up who aren't required, Dr. Weinstein said, “then you have to use resources to tell them they're not needed. That's a problem.”

Medical personnel should activate only if contacted through special channels. “If you're not asked to be there by an official channel, don't go,” he said.

Information Is Power

Although primary data are needed to determine where improvements should be made, access to critical information may be hindered by the difficulties researchers have retrieving data from the National Disaster Medical System (NDMS), Dr. Bern said.

“One of the problems from the standpoint of lessons learned and scientifically evaluating what is going on relates to how easy it is for researchers, policy makers, or anyone else to get their hands on the information,” Dr. Bern said.

Access to needed records, including paper patient records, is a “very challenging if not impossible task” under the structure of the NDMS, the Federal Emergency Management Agency, and the U.S. Department of Homeland Security, he said.

The data could help experts assess whether medical teams responded as efficiently as they could have, were in the right locations, and had the correct supplies, among other issues.

As recovery continues, the experiences from Katrina offer myriad opportunities for improvement of medical disaster response, Dr. Weinstein said. “There's a lot to learn here in a nonpunitive manner,” he said.

Dr. Hirshon agreed. “I think we need to be cautious in criticizing what went on [during Katrina], because there's still a lot of learning that needs to be done and a lot of understanding of what's going on,” he cautioned. “This is such an unusual event.”

From safety concerns to the problem of well-meaning but excess emergency personnel, lessons are emerging in Hurricane Katrina's aftermath that should reshape how emergency medicine and disaster management systems respond to future catastrophes.

Planners have focused on contingencies if parts of cities or some streets and services were disrupted by a disaster for a number of blocks—but not when all services, health facilities, and communications were obliterated in an area the size of Great Britain—as occurred with Katrina—said ACEP Public Health Committee Chair Jon Mark Hirshon, M.D.

“One of the things I think people need to realize is that we've been planning for disasters for years, but [Katrina] is by definition a catastrophe,” Dr. Hirshon said.

Although emergency medicine leaders said the profession responded admirably to the Katrina crisis, the overall chaotic nature of Gulf Coast rescue operations leaves many areas for study through emergency plan reviews and academic research.

Safety First

The need to focus on safety was a primary lesson inflicted by Katrina.

Medical personnel should have been more alert to potentially violent situations and planned accordingly, said ACEP Disaster Medicine Section Chair Eric Weinstein, M.D. “If you work in a daily environment—fire, rescue, EMS—with gunfire, then you have to assume it's going to be there in a disaster,” he argued.

Responders “didn't think it through. They figured that these people were helpless and wanted help, which was true, but they also then realized that there were hungry people out there with guns—plus there were bad guys out there looking to seize upon the situation,” he explained.

Medical personnel should coordinate with security organizations during disasters to make sure they are accompanied by adequate protection, Dr. Weinstein said.

Dr. Hirshon agreed, saying that violence toward responders not only threatens individuals but also costs rescue operations. “It is unwise to put yourself in harm's way, because you could end up being a casualty and becoming a burden on the system,” he said.

Protection should be required of hospitals as well, which were reportedly faced with armed looters in the hurricane's aftermath. Dr. Weinstein suggested that hospitals have “hired gunmen” who can protect patients and hospital supplies.

Physicians should take a lead role in determining the evacuation abilities of vulnerable individuals, another major problem in New Orleans, Dr. Weinstein added. “I think that the medical community let down, because I think [it] should be more attuned to the patient's ability to evacuate,” he said.

“Health care providers can do a better job. They teach people how to eat, they teach people not to smoke and to have healthy lifestyles; let's talk about how [each patient] is going to evacuate,” he suggested.

If patients do not have the resources to get themselves out, he said, physicians should ask if patients object to them notifying a public agency that could coordinate transportation for the patient during an emergency. The agency should be alerted to patient medications and any other special needs.

Red-Tape Tangles

Bureaucratic steps involved in medical personnel deployment need to be reviewed, Dr. Hirshon said, including the possibility of portable credentials that can apply to multiple jurisdictions in emergencies.

He also suggested strengthening the response command and control structure, which he said “was fragmented initially.” Knowing who is in charge when multiple jurisdictions respond is something that needs to be worked out beforehand, he said.

Disaster response planning has always assumed the local jurisdiction would respond first, followed by states, and then the federal government, “which may take as long as 3–4 days,” noted Andrew I. Bern, M.D., past chair of ACEP's Disaster Medicine section. That process needs to be reviewed, he said, in light of the hurricane's devastating effects.

“The federal government doesn't have the precedent, up until now, where the expectation was that they would immediately take over the management, coordination, and running of the entire event,” Dr. Bern explained.

Another area of concern, experts said, is excess personnel.

When volunteers show up who aren't required, Dr. Weinstein said, “then you have to use resources to tell them they're not needed. That's a problem.”

Medical personnel should activate only if contacted through special channels. “If you're not asked to be there by an official channel, don't go,” he said.

Information Is Power

Although primary data are needed to determine where improvements should be made, access to critical information may be hindered by the difficulties researchers have retrieving data from the National Disaster Medical System (NDMS), Dr. Bern said.

“One of the problems from the standpoint of lessons learned and scientifically evaluating what is going on relates to how easy it is for researchers, policy makers, or anyone else to get their hands on the information,” Dr. Bern said.

Access to needed records, including paper patient records, is a “very challenging if not impossible task” under the structure of the NDMS, the Federal Emergency Management Agency, and the U.S. Department of Homeland Security, he said.

The data could help experts assess whether medical teams responded as efficiently as they could have, were in the right locations, and had the correct supplies, among other issues.

As recovery continues, the experiences from Katrina offer myriad opportunities for improvement of medical disaster response, Dr. Weinstein said. “There's a lot to learn here in a nonpunitive manner,” he said.

Dr. Hirshon agreed. “I think we need to be cautious in criticizing what went on [during Katrina], because there's still a lot of learning that needs to be done and a lot of understanding of what's going on,” he cautioned. “This is such an unusual event.”

From safety concerns to the problem of well-meaning but excess emergency personnel, lessons are emerging in Hurricane Katrina's aftermath that should reshape how emergency medicine and disaster management systems respond to future catastrophes.

Planners have focused on contingencies if parts of cities or some streets and services were disrupted by a disaster for a number of blocks—but not when all services, health facilities, and communications were obliterated in an area the size of Great Britain—as occurred with Katrina—said ACEP Public Health Committee Chair Jon Mark Hirshon, M.D.

“One of the things I think people need to realize is that we've been planning for disasters for years, but [Katrina] is by definition a catastrophe,” Dr. Hirshon said.

Although emergency medicine leaders said the profession responded admirably to the Katrina crisis, the overall chaotic nature of Gulf Coast rescue operations leaves many areas for study through emergency plan reviews and academic research.

Safety First

The need to focus on safety was a primary lesson inflicted by Katrina.

Medical personnel should have been more alert to potentially violent situations and planned accordingly, said ACEP Disaster Medicine Section Chair Eric Weinstein, M.D. “If you work in a daily environment—fire, rescue, EMS—with gunfire, then you have to assume it's going to be there in a disaster,” he argued.

Responders “didn't think it through. They figured that these people were helpless and wanted help, which was true, but they also then realized that there were hungry people out there with guns—plus there were bad guys out there looking to seize upon the situation,” he explained.

Medical personnel should coordinate with security organizations during disasters to make sure they are accompanied by adequate protection, Dr. Weinstein said.

Dr. Hirshon agreed, saying that violence toward responders not only threatens individuals but also costs rescue operations. “It is unwise to put yourself in harm's way, because you could end up being a casualty and becoming a burden on the system,” he said.

Protection should be required of hospitals as well, which were reportedly faced with armed looters in the hurricane's aftermath. Dr. Weinstein suggested that hospitals have “hired gunmen” who can protect patients and hospital supplies.

Physicians should take a lead role in determining the evacuation abilities of vulnerable individuals, another major problem in New Orleans, Dr. Weinstein added. “I think that the medical community let down, because I think [it] should be more attuned to the patient's ability to evacuate,” he said.

“Health care providers can do a better job. They teach people how to eat, they teach people not to smoke and to have healthy lifestyles; let's talk about how [each patient] is going to evacuate,” he suggested.

If patients do not have the resources to get themselves out, he said, physicians should ask if patients object to them notifying a public agency that could coordinate transportation for the patient during an emergency. The agency should be alerted to patient medications and any other special needs.

Red-Tape Tangles

Bureaucratic steps involved in medical personnel deployment need to be reviewed, Dr. Hirshon said, including the possibility of portable credentials that can apply to multiple jurisdictions in emergencies.

He also suggested strengthening the response command and control structure, which he said “was fragmented initially.” Knowing who is in charge when multiple jurisdictions respond is something that needs to be worked out beforehand, he said.

Disaster response planning has always assumed the local jurisdiction would respond first, followed by states, and then the federal government, “which may take as long as 3–4 days,” noted Andrew I. Bern, M.D., past chair of ACEP's Disaster Medicine section. That process needs to be reviewed, he said, in light of the hurricane's devastating effects.

“The federal government doesn't have the precedent, up until now, where the expectation was that they would immediately take over the management, coordination, and running of the entire event,” Dr. Bern explained.

Another area of concern, experts said, is excess personnel.

When volunteers show up who aren't required, Dr. Weinstein said, “then you have to use resources to tell them they're not needed. That's a problem.”

Medical personnel should activate only if contacted through special channels. “If you're not asked to be there by an official channel, don't go,” he said.

Information Is Power

Although primary data are needed to determine where improvements should be made, access to critical information may be hindered by the difficulties researchers have retrieving data from the National Disaster Medical System (NDMS), Dr. Bern said.

“One of the problems from the standpoint of lessons learned and scientifically evaluating what is going on relates to how easy it is for researchers, policy makers, or anyone else to get their hands on the information,” Dr. Bern said.

Access to needed records, including paper patient records, is a “very challenging if not impossible task” under the structure of the NDMS, the Federal Emergency Management Agency, and the U.S. Department of Homeland Security, he said.

The data could help experts assess whether medical teams responded as efficiently as they could have, were in the right locations, and had the correct supplies, among other issues.

As recovery continues, the experiences from Katrina offer myriad opportunities for improvement of medical disaster response, Dr. Weinstein said. “There's a lot to learn here in a nonpunitive manner,” he said.

Dr. Hirshon agreed. “I think we need to be cautious in criticizing what went on [during Katrina], because there's still a lot of learning that needs to be done and a lot of understanding of what's going on,” he cautioned. “This is such an unusual event.”