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Posts Tagged ‘Reform’

Uwe Reinhart on the current state of reform

January 26th, 2010

Uwe Reinhart offered some perspective on the current state of healthcare reform during a keynote speech at Community Hospital in Monterey, Calif. Here’s a summary from the Monterey County Herald:

Reinhardt represented America as an ill-equipped motorcyclist about to crash.

“We can see these rugged bikers roaring past our cars … T-shirts flapping in the wind, with a bandanna at most as protective headgear,” Reinhardt wrote.

“Even if the motorcyclist had little savings and did not carry health insurance, he surely would expect to be taken by ambulance or helicopter to the nearest hospital emergency room for whatever treatment was critically needed, however expensive.”

Renhardt believes that this irresponsible attitude drives up health care costs for everyone.

As an example, Reinhardt asked the Community Hospital audience to imagine a blue-collar American couple working in retail or at a big-box store. Together, he said, they might bring home $40,000 a year. But the Milliman Medical Index, which benchmarks total heath spending for a typical American family of four, said average costs are currently around $16,700 a year. This makes standard health care expenses 42% of income.

“This will only get worse,” Reinhardt cautioned, because wages are not rising fast enough to cover health care.

Assuming current trends in growth of health care costs and wages, he showed that in 2019 more than half of that same family’s wages could go to health care.

Reinhardt described the American middle class as “sailing into a perfect storm.” Lower-class families are beginning to be priced out of health care and middle-class families will be increasingly uninsured to save money, he warned.

Reinhardt described three things needed for basic health care reform:

· Many young, healthy people with few costs to offset the older, unhealthy few who rack up huge bills.

· A large number of insurance subscribers to make it economically viable for insurance companies.

· Adequate subsidies toward the purchase of health insurance for consumers.

“It’s like a three-legged stool,” Reinhardt emphasized. “You can’t sit on it for very long if it has two legs.”

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The cost challenge

May 4th, 2009

The challenge facing health reformers is nicely framed in a new article by Milliman principals Clark Slipher and Ron Harris. Quoting from the article:

No system is perfect and there is no single pathway to success. Geographic, financial resource, and population disparities (among others) preclude adoption of a single methodology to achieve “well managed” status universally. Still, we have concluded that a reduction in overall healthcare costs in excess of 25% would be possible if care were delivered under best observed practices.

As we discussed a few weeks ago, this number squares with the waste estimates posited by Peter Orszag. Where are the opportunities for greater improvement?

Our experience with top-performing systems does show opportunities for efficiency improvements in practically all service categories, but especially in facility-based care. With shifts in the types of treatment and places of service under best-observed clinical practices, certain categories would increase accordingly.

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Could electronic health records become a catalyst for other changes in the healthcare industry?

February 13th, 2009

Mike Kreidler, John Hammarlund, George Scriban, Scott Armstrong, and Ron Sims  discuss EHR as a catalyst for healthcare reform, responding to a question submitted by Cody Augdahl.

For submitting this question, Cody Augdahl is a finalist in our question contest. Congratulations, Cody.

Transcript:

Q: I have another question that came from someone who submitted one before the event; it was submitted via e-mail. It’s kind of an interesting question. It asks us to imagine the day when, in fact, a majority of the U.S. population has adopted personally controlled health records. What kind of impact would that have more broadly on the system potentially, do you think? I mean, it’s a little bit hard to put ourselves out there and imagine the circumstance, Mike, but could you see how that might be a catalyst for other change?

Mike Kreidler: I think you need a great deal more transparency in the system than you have right now, and that’s one of the real problems. You can’t even do any accounting in the system right now because of the variation that you have. 

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