Health Care CEOs Pushing Fundamental Reform?
To be honest, I was a little taken aback by some of the points that I read. Not only were the academics pushing for fundamental health care reform that would result in restructuring the system and providing universal coverage, but a few of the execs did the same.
In the words of Froedtert Hospital CEO William Petasnick:
We've had 14 years of basically market-driven solutions. And market-driven solutions work up to a point, but I think the outgrowth of the failure of market-based solutions is . . . the 45 million Americans who are outside of the market.Here's Columbia St. Mary's CEO Leo Brideau:
If you take a look at a dollar spent on health care premiums today, about 70 cents of that gets spent on health care. The other 30 cents of that goes to shareholders in those insurance companies or to administrative costs.And Medical College of Wisconsin CEO T. Michael Bolger:
And it seems to me that when the government can manage the Medicare and Medicaid program for about 3% or 4% administrative costs, we ought to be asking insurance companies . . . why is it costing them 30%?
I think the health care system is broken in America. And . . . this country has not made a fundamental decision, and that is whether health care is a right of citizenship in a Jeffersonian democracy or whether it's a privilege for those who can afford to pay for it. . . .
Until we do answer that question, we will not be able to derive a health care system that is going to be fundamentally fair and equitable to the people of this country. I think that the current system of an employer-based reimbursement system in our country is unsustainable. . . .
The failure of market-based solutions, excess administrative costs, government efficiency, health care as a right, the need to end employer-based insurance -- I thought for a bit that I was reading some reincarnation of Pravda!
Part of this, of course, was just plain old finger pointing. Aside from a couple of swipes at drug companies and medical equipment manufacturers, the bulk of the target practice -- at least that of the execs -- was aimed at the insurance industry.
This is an interesting outcome considering most observers put the health system industry right alongside the insurance industry in the fight against fundamental reform. You can bet that just about any of the three proposals being considered by the legislature will have an opponent in both the Wisconsin Hospital Association and the Coalition for Sensible Health Care Solutions (an umbrella group for the insurance industry in the state).
I have little doubt that if the JS invited just insurance industry execs along with a couple of academics to the talk, the finger pointing would've been aimed at the big health systems that have been raking in near double-digit profit margins -- in spite of their non-profit status -- along with increasing their oligopoly status and, as a result, their negotiation position against payers through heightened consolidation in recent years.
As an article in the Denver Business Journal documented last August, all of the major players -- providers, insurers, Big Pharma, etc. -- are making lots of cash in our current system, and so all of them aren't going to jump at the chance to fundamentally change it.
Which brings us back to the question: So why did the provider industry execs not only point the finger elsewhere, but also sound like true reform proponents in their roundtable talk?
Part of me wants to believe that they do truly see the benefit in fundamental reform. Sure, they're making money now, but their industry is also under constant criticism, which inherently breeds instability. And getting the system as a whole on solid footing doesn't mean profits need to -- or even should -- evaporate.
But there also could be a subtle opposition within the verbal support for reform. After all, it's not a lack of public will that's preventing fundamental reform -- surveys show enormous support for doing away with our existing system. Rather, the same disease that's killing the system is killing reform: fragmentation.
The mere fact that there are a number of major players in the current system assures that any reform plan is not only going to be attacked from multiple sides, but also attacked from multiple sides by organized groups with plenty of special interest cash to do their convincing. It's easy enough for one segment to talk the talk of reform -- and save face in the process -- knowing that it would require far more than just talk to actually get anything done.
At one point in the roundtable talk, Aurora exec Sue Ela harked back to the early 1990s when special interests killed the Clinton health care reform plan, and she wondered if there would be enough political will to get something accomplished this time around.
She should really be asking the special interests that represent her organization and others at the table why so much political will is necessary when so much public will is already there.
Labels: health care