Summary
With so much of the spotlight the past month on "death panels" and other myths of health care reform, the more prosaic (but ultimately most significant) goals and objectives of reform have been lost amongst the cacophony. Ten undisputed national experts of various stripes across the bipartisan political spectrum have tried to bring us all back to a more cool headed reality as we enter the momentous make or break Autumn period for national health care reform.
Analysis
Virtually no national expert on health care believes that the system, the economy or the country can continue on its present trajectory of unsustainable growth in expenditures. The best that can be hoped is to be able to extend coverage to as many of the almost 50 million uninsured (especially children) over the next 10 years, while at least "bending the health care cost growth curve" down to a trajectory which will not bankrupt the system itself and the overall economy by the year 2040, if not sooner.
Ten undisputed national experts with a total amongst them of at least 300 intensive years of study of the health care system at the highest levels of the private and public sectors representing all points on the political ideology spectrum have come up with four pillars of a strategy to prevent the nightmare scenario which doing nothing to reform the system now will almost surely create in the decades ahead. These four pillars are:
1. Invest in better information and tools, such as health IT as a foundation to guide and support a reformed system. This includes providing liability protections for following best practices provided at the point of care by these technologies identified by comparative effectiveness research.
2. Transition to accountable payment systems that reward providers for delivering lower cost, high quality care. This should be reinforced to make fee for service less attractive over time. There also needs to be an independent entity with authority to ensure that steps to improve Medicare and Medicaid sustainability are addressed by Congress.
3. Restructure nongroup and small group health insurance markets and coverage subsidies based on an exchange model that pools risk outside of employment and promotes competition on cost and quality (i.e. value based purchasing and insurance design). Early reports on pilot projects promoting these practices have had very favorable results.
4. Support and encourage better individual choices to enhance the patient role in improving health and lowering health care costs. Reforms should support premium rebates for measurable health improvements. Prevention investments should evaluate measurable strategies for helping individuals to lose weight and achieve other health improvements.
Variations of these pillars may be found in the five health care bills (three in the House and two in the Senate) which will form the basis of national health care reform legislation to be debated in both Houses this Autumn. However, these most important aspects of these bills have not received the attention they deserve because, at least among those attending all the raucous rallies of the past month, they either are not understood and/or are not terribly controversial. In any event, the general press has not seen fit to date to publicize these parts of the bills very much. Yet, getting these aspects of these bills through the Congress and to the President's desk would do more to transform the health care system than any of the other parts of the current bills which have been generating all the misinformation and disinformation during the past month in the Town Halls.
Companies poised to benefit by the passage of these four pillars of health care reform include:
1. Premier, Inc.
2. IBM;
3. CSC;
4. Accenture;
5. Healthways.
6. General Electric;
7. Siemens;
8. McKesson;
9. Eclipsys; and
10. Cerner.
This author consults with leading institutions through GLG
Analyses are solely the work of the authors and have not been edited or endorsed by GLG.
