Lawmakers fail to renew health-care watchdog

While other states are increasing their ability to track health-care costs and quality, Pennsylvania is poised to move in the opposite direction.

Yesterday, the state Senate adjourned for the year without reauthorizing the Pennsylvania Health Care Cost Containment Council, an independent state agency that since 1986, with the support of businesses and unions, has helped pioneer public reporting of hospital quality and costs.

"I don't understand how a state that is a recognized leader in the area of health-care quality and cost reporting . . . can sit back and let an organization like this die," said Catherine A. Gallagher, president of the Lehigh Valley Business Coalition on Health Care.

The agency, known simply as PHC4, has been operating under an executive order since July, when its reauthorization bill was entangled in an unrelated political fight between Gov. Rendell and Senate Republicans over the governor's proposal to offer health insurance to many of the state's 800,000 uninsured adults.

This summer, Rendell rejected a bill to reauthorize the agency that included an extension of subsidies to doctors for their medical malpractice coverage. Rendell tied the extension of those malpractice subsidies, known as the MCARE abatement, to passage of his insurance plan.

This week, negotiations between the administration and Senate Republicans failed to reach a compromise on health coverage for the uninsured, MCARE abatement, or PHC4 reauthorization.

On Tuesday afternoon, the administration rejected what it said was a verbal offer from the Senate Republicans to add $50 million to the state's low-cost insurance program, adultBasic. That would have added about 14,000 people to the program that has a waiting list of 118,000 uninsured Pennsylvanians, the administration said.

Earlier, in a letter to GOP leaders, Rendell proposed adding at least 100,000 people to adultBasic and expanding the program benefits to include prescription drugs and mental-health coverage.

Since no deal was reached, Erik Arneson, a spokesman for Senate Majority Leader Dominic Pileggi (R., Delaware County), said Rendell should extend his executive order so the PHC4 could continue to operate into next year, to allow more time for negotiations.

Donna Cooper, Rendell's policy director, would not comment on the future of the agency, which has an annual budget of $5 million and 40 employees.

Gallagher and others expressed concern that, in the end, the politicians would take away PHC4's strongest asset, its independence, even if the governor allowed it to operate past Nov. 30, when his July deadline was set to expire.

The council has long been governed by a majority of members from businesses and unions. But in recent years, hospitals have been exerting more pressure on the agency, particularly about its efforts to report on so-called hospital-acquired infections and the payments for various treatments, Gallagher said.

"Hospitals don't want that [information] out there," she said.

Roger Baumgarten, a spokesman for the Hospital & Healthsystem Association of Pennsylvania, said the lobbying group "has supported, and continues to support, legislative reauthorization of PHC4."

Last month, the agency issued two major reports, one on heart surgery and another on performance of hospitals in 51 categories of care from abnormal heart beats to strokes. Unlike other states, the council's reports detail how well hospitals performed, based on patient outcomes.

"We are hugely disappointed that it wasn't reauthorized," said Gene Barr, a spokesman for the Pennsylvania Chamber of Business and Industry. "This takes away one tool that allows us look at health-care costs and how we might control them."