How to Fix Healthcare: Get the Smartest People Together and Find Common Ground
America's Patient Protection and Affordable Care Act has plenty of enemies, but the biggest problem with the law isn't that parts of it, including the individual mandate, have become politically radioactive. The biggest problem is that while the law goes a long way to expand the population of people with health insurance, it doesn't comprehensively address an even bigger problem–the unsustainable cost of the country's healthcare system. Here's a killer factoid for you: it is estimated that by 2018, partly due to the addition of 32 million people to the ranks of the insured, the annual bill for healthcare in the country will swell from $2.5 trillion to $4.3 trillion–or about 20% of GDP.
These facts came to the fore during a panel discussion between five of the top healthcare experts in the country that was conducted by Bloomberg BusinessWeek at its HQ in New York on Jan. 26. Video clips were posted on the publication's Web site today. (The event was sponsored by IBM, which was why I was invited.)
The title of Bloomberg's discussion series is "Fix This," and while it's clear that fixing the healthcare system will take more than an enlightened group discussion on a Thursday night in New York City, the quality of the expert's comments pushed me to a firm conviction: The way to fix healthcare is to get the smartest people together from all segments of the system–including government–and call on them to find common ground because the nation's financial viability depends on it.
Here's a hopeful message about the potential of healthcare reform from Dan Pelino, General Manager, IBM Healthcare and Life Sciences, who introduces Bloomberg's video package.
The Bloomberg panel was made up of a Dream Team of healthcare experts. The panelists included Ronald Williams, former CEO of Aetna; Gregory Curfman, executive editor of the New England Journal of Medicine; Gail Wilensky, a senior fellow at the international health foundation Project Hope and a former director of Medicare and Medicaid during the administration of President George H.W. Bush; Jonathan Bush (the president's nephew), the CEO of athenahealth, a major provider of information technology services for the healthcare industry; and Ralph de la Torre, CEO of Steward Health Care System, on of the best managed hospital companies in the country. The panel was moderated by Norman Pearlstine, Bloomberg LLC's chief content officer.
The discussion was wide ranging, but Pearlstine kept pushing the panelists back to the essential question: What's it going to take to fix healthcare? Here's the prescription that I drew from their responses:
Integrate the pieces: Physicians, hospitals and insurance companies need to be better integrated with one another so they can coordinate care for patients and deliver it in ways that are most effective and efficient. Steward is a model for this approach on the physician-hospital front.
Put the patient at the center: If you design a patient-centered system, you'll get better outcomes. There's also a better chance that the participants will focus more on preventative care, and that individuals will begin to take more responsibility for their health–including crafting more healthy lifestyles.
Change the incentives: Shift away from paying for individual services rendered to successful outcomes. Value quality over quantity.
Adopt technology: Of all the major industries in the United States, healthcare has been the slowest to adopt new technologies. And it shows. The Obama administration's program for helping physicians and hospitals implement electronic medical records is a start, but digital records won't fulfill their potential until insurance companies, government agencies, hospitals and physicians share data seamlessly.
de la Torre had the most dire view of the consequences of not fixing healthcare. We're headed for near bankruptcy as a nation. His hope is that the crisis will force the many factions and interest groups to come together and, finally, fix the system.
If that sane thing happens, the conveners of the initiative would do well do invite this group of experts to the table to help craft solutions.