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Collaborative Future: Post 77

I had the pleasure last weekend of attending The Future of Medicine: An Expert Diagnosis, at my alma mater, the University of Rochester.  Here I am introducing Dr. Mark Taubman, the Acting CEO of the University of Rochester Medical Center.

Other Panelists included: Paul Keckley, Executive Director, Deloitte Center for Health Solutions, Daniel Sisto, President, Healthcare Association of New York State, and David Klein, CEO of The Lifetime Healthcare Companies, below.

Mr. Keckley pointed out that over 60% of our $35 trillion national debt is healthcare related.  So far, the US economy has shed over 6 million jobs during our current recession, but healthcare has added approximately 300,000 jobs over the same timeframe.  Decreasing healthcare costs by 1.5% per year for 10 years would save approximately $3 trillion.

Mr. Sisto, summarizing the events of last summer, defined a myth as a popular belief or tradition that serves to explain the mindset or world-view of a group.  He described politics as the manipulation of people by playing into their myths.  He described the maneuvering that is taking place, even though Democrats hold 256 seats in the House of Representatives, because 57 members of the Progressive Caucus, committed to the passage of the public option, are balanced by 52 Blue Dog Democrats, who resist activities that enlarge government.  Furthermore, 49 House Democrats were elected from districts that voted for John McCain in the 2008 Presidential election, making them wary of appearing to overreach.

He also explained that one reason for the difference in cost of the Senate Finance Committee Bill (approximately $829 billion) and the House bills (approximately $1.2 trillion) is that the House provides a 10-year fix to Medicare physician fee cuts, but the Senate bill addresses only the first 2 years.  Without intervention, Medicare payments to physicians will be cut 21.5% in 2010.  In 2007, Medicare accounted for 17% of Federal spending, and Medicaid accounted for 7% of Federal spending.  To learn more about differences between the current House and Senate bills, please read Rehabilitating Healthcare in the LA Times October 14, 2009.

Mr. Klein pointed out that the current legislation before Congress does not provide significant cost containment.  Approximately 3/4 of the average annual family policy cost of $12,700 is borne by employers.  As Medicaid coverage expands, states face either cutbacks in other budget categories or increased income and/ or property and sales taxes to fund this expansion.

Despite the challenges, the panelists made me feel that the future of US medicine is bright, provided that we can identify and implement ways to decrease waste and inappropriate care.  This panel summarized a great deal of data into actionable information.  I thank the panelists for traveling to Rochester to educate us on the challenges and opportunities that we face in the coming months and apologize if I have misquoted them or left out any important information in this brief summary.

What do you think?

• Do you find the current state of affairs confusing regarding healthcare reform
• Do you feel that the healthcare cost pressures we face are unsustainable
• Do you find that the opportunities for reform balance the current challenges

As always, I welcome your input to improve healthcare collaboration.

Kenneth H. Cohn

© 2009, all rights reserved

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