Public health experts from inside and outside the Beltway gathered at the Newseum Thursday to discuss the recently enacted health care legislation.
Listen to the session here:
Joseph R. Antos, Wilson H. Taylor Scholar in Health Care and Retirement Policy, American Enterprise Institute
Richard Barasch, Chairman and Chief Executive Officer, Universal American Corp.
Carolyn Barley Britton, Past President, National Medical Association
Jonathan Blum, Deputy Administrator, Center for Medicare Centers for Medicare and Medicaid Services, United States Department of Health and Human Services
Susan Blumenthal, Director of the Health and Medicine Program, Center for the Study of the Presidency
Stephan Bour, Associate Director for Biomedical Informatics and Chief Information Officer, National Heart, Lung, and Blood Institute, National Institutes of Health, United States Department of Health and Human Services
Joseph P. Cook, Economic and Policy Analysis, Pfizer
Bill Crounse, Senior Worldwide Director of Health, Microsoft
Karen Davis, President and Chief Executive Officer, The Commonwealth Fund
Lawrence Gostin, Professor of Global Health Law, Georgetown University Law School
Mary Grealy, President, Healthcare Leadership Council
Tim Gronninger, Senior Staff, Health Committee, United States House of Representatives
Richard Hatchett, Director for Medical Preparedness Policy, Executive Office of the President
Bob Kocher, Director, McKinsey Center for U.S. Health System Reform
Ralph Neas, President and Chief Executive Officer, National Coalition on Health Care
Uwe Reinhardt, James Madison Professor of Political Economy, Professor of Economics and Public Affairs, Princeton University
John Short, Chairman and Chief Executive Officer, Rehab Care
At the close of the Washington Ideas Forum session entitled, "Health Care Reform: Bending the Cost Curve," panel participant Karen Davis, President of the Commonwealth Fund, praised the forward-thinking, innovative nature of the morning's discussion. "I like the unleashing of creativity in the room," she explained. "I'm skeptical of a lot of the ideas, but I think a lot of good things can come from everyone working in their own spheres. And as opposed to looking back, fighting old wars, this kind of forward thinking will be the key."
Davis touched upon one of the overarching themes to emerge from the morning's session: though the current American health care system is gravely flawed, panelists argued, the passage of the health care bill has also created space to pursue exciting new avenues of reform. Many participants highlighted specific experimental programs that have been successful in both decreasing costs and improving care.
"[Health care reform] is the most important legislation passed in the last 50 years. It's not perfect, and there is sausage, but it did accomplish important goals. There is potential for cost containment, but it's not the most critical thing. Some of the competitiveness fell away when you took away the public option, but I think it has the potential for cost payment. I think all of the necessary things are in place to bring down costs."
-- Carolyn Barley Britton, Associate Professor of Clinical Neurology at Columbia University
Throughout the morning, specific target areas for health care cost reduction also emerged, including: improved access to preventive care, the implementation and utilization of new health care technologies (including a national health care information technology system), the implementation of employer-sponsored "wellness programs," improved access to primary care, and an altering of incentives to effect change in both patient and doctor behavior. Also necessary, participants argued, is a realistic assessment of the level of political will available to implement reform.
"There are three ways that other countries save costs and do better: 1) Cost effectiveness is tied to outcome. Who wouldn't want to know better what works better at a lower cost? 2) We don't leverage our buying power. We pay top price for pharmaceuticals, subsidizing other countries treatment, and 3) Creating a budget ceiling, and trying to make choices within that budget."
--Lawrence Gostin, Director, Centers of Law and Public Health at Johns Hopkins and Georgetown University
Three Big Ideas from our Health Care Experts:
1. Compared with Americans, Europeans pay less for health care while utilizing it far more frequently. But is the problem in the United States cost, or is it utilization? Uwe Reinhardt, Professor of Economics and Public Affairs at Princeton University, argued that the "the real problem with American health care is not that we're heavy users of healthcare. The Swiss have more doctors, more hospital beds, use more pills. The problem is the cost. We pay more than everyone else." Yet John Short, the President and CEO of the RehabCare Group, argued from the opposite perspective. "The issue is not only the price," explained Short. "To me, the issue is utilization."
2. One of the most promising areas for reducing costs and improving preventive care, participants argued, is the employer-sponsored wellness plan. Panelists cited various examples of companies successfully reducing health care costs by incentivizing healthy behavior and creating a 'culture of health' in the workplace, including wellness programs enacted by General Electric, Johnson & Johnson, and Dow Chemical Company.
3. Panelists debated the potential cost-reduction benefits of improved access to preventive care. While many participants cited the benefits of allocating greater spending to preventive care rather than treatment, Cheryl Healton, the President and CEO of Legacy, emphasized that "not all forms of prevention have equal cost benefit and an equal impact on cost."