Yesterday, I attended panels at the Cato Institute’s Conference on Health Care Reform on health care delivery system reform and perspectives on reform from two U.S. Congressmen. The panel on reforming the health care delivery system was moderated by Susan Dentzer from Health Affairs and included speakers with business and health policy backgrounds who all agreed that the delivery system is broken and inefficient but differed on which aspects should be changed or rebuilt.
Shannon Brownlee, a fellow of the New American Foundation, and Alain Enthoven, PhD, emeritus professor of Stanford University, agreed that physicians lack the knowledge of how the efficacy of treatments over time. Brownlee pointed to a “lack of evidence” that creates this problem, and Enthoven thought that improved health records and coordinated care would allow the improvement of treatments over time.
Regina Herzlinger, PhD, of Harvard Business School saw the answer to delivery system reform in transitioning from care organized like “mom and pop” firms to a “focused factory” system, in which chronic diseases would be managed by integrated teams of caregivers and personnel. A small number of these “focused factories” in a region would be able to compete and hold each other accountable for quality of care. The general impression of Herzlinger’s solution was that it was innovative, but infeasible.
Kaiser Permanente and the Mayo Clinic were recurring themes in the conversation, both serving as examples of institutions that have cut costs and improved health records.
Representatives Michael Burgess (TX) and Jason Altmire (PA) gave their thoughts on health reform in a lunchtime panel. For Burgess, who was a practicing physician for years before entering Congress, affordability of care is a top priority because it impacts access to care. From his district’s perspective, concerns about the uninsured lead to the immigration debate, which Burgess thinks needs to be solved before solutions are created for health care reform. He wants to find a way to restructure the system without disrupting the people who are already happy with their health care.
Altmire began his remarks with the premise that we have the best health care system anywhere in the world, but it costs too much and the costs are unsustainable. He pointed out that prevention and wellness practices are not reaching the uninsured. Altmire believes that solutions for health care will be found in the middle of the political spectrum. In the discussion period, in which many questions in the audience came from physicians practicing across the country, Altmire said that younger, healthier people need to be driven into the health care system even if they do not need care right away.
Tags: Cato Institute, health reform