Three experts weigh in with advice for the president on health-care reform

San Francisco-What advice would you give to President Obama to help navigate health-care reform? Three people well acquainted with the challenges that the president will face answered that question here at Glaucoma Day.

William L. Rich, III, MD, FACS, medical director of health policy, American Academy of Ophthalmology, said the best thing for President Obama to do is ignore what happened during the Clinton Administration, when health-care reform was addressed using an insular, academic approach.

"[The president] should do what I think he’s doing: involve the health-care professions, the insurers, and the business people, because we really have a financial crisis in our country," Dr. Rich said. "You’re not going to solve a financial crisis with an academic exercise."

Priscilla P. Arnold, chairperson, government relations, American Society of Cataract and Refractive Surgery, said she would advise President Obama not to think of health information technology as a cure-all.

"I would advise him to prioritize the changes that need to occur," she said. "Health information technology is a very popular topic in Washington, DC. There’s a tendency to think it can fix everything, but the priority has to be making sure the underlying framework to support it is in place."

John Pinto, of the ophthalmic management consulting firm J. Pinto & Associates, said he would tell President Obama that peer-based and peer-driven utilization and review, from the bottom up rather than from the top down, is the way to go.

"I visit a lot of practices, and in some, the utilization rate of YAG capsulotomy is 18%, and in others it’s 80%," he said. "That’s just one example. Across the board, there’s a wide range of utilization of procedures."

Peer review of utilization rates is a good place to begin if the goal is to reduce the unsustainable 17% of the gross domestic product that is spent on health care to a more sustainable 12% to 13%, Pinto said.