Health Reform: Where Do We Go From Here?

Experts discuss issue at SPH roundtable

Health care needs to change, and it will, one way or another. That’s the uncomplicated fact agreed upon by a panel of experts at the most recent School of Public Health Roundtable, “Leadership Essentials in the Era of Health Reform.”

The roundtable kicked off with a keynote address delivered by George Halvorson, chairman and chief executive officer of Kaiser Permanente, the nation’s largest nonprofit health plan and hospital system. Halvorson spoke of the need to change processes in health care delivery.

He noted that 1.7 million people get sick each year—or sicker—as a result of hospital-associated infections. The outcome of this irony is billions of dollars in treatment and tens of thousands of deaths annually.
Some other startling statements from Halvorson:

• People diagnosed in the late stages of cancer who go on to receive standard treatment such as chemo or radiation live 29 days fewer than people who simply enter hospice.
• We treat diabetes correctly only 8 percent of the time.
• We treat asthma correctly only about half the time—and we don’t know which half we’ve treated correctly.
• If people walked 30 minutes, four days per week, diabetes would be cut by 40 percent—and by 60 percent if a person also lost 10 pounds. The Medicare system, which is on course for insolvency, could be saved by this action alone.

SPH associate professor Daniel Zismer echoed that last thought in a panel discussion following the lecture, saying that health care is geared not toward keeping people healthy, but to help them once they’re sick. The issue, said Zismer, is “will patients do their part [to keep healthy]?”

Halvorson said the health care system will be moving toward team care (with, say, a nutritionist sitting alongside a cardiologist), preventive measures, patient focus, and a universal medical database for tracking treatment and outcomes.

As for health care reform legislation itself, SPH professor Lynn Blewett said it will likely go up for a “repeal all” vote in the House. While that probably won’t pass the Senate, Congress will start to look at specific pieces to take out of the bill.

“The question is,” said Blewett, “what components will they pull and what are the costs associated with them?”

Watch a video presentation of “Leadership Essentials in the Era of Health Reform.”

“We are on a trend line where we will bankrupt the country in 20 or 30 years if we don't radically address the way care is delivered and paid for in the United States.” David Tilford , president and CEO, Medica

"For states moving ahead on reform it’s this tension of "hurry up, get things done" and then at the same time "what’s going to happen and what parts of reform will they peel off in the next Congress?" Lynn Blewett, SPH Professor

"Most providers realize that reform is inevitable. Reform is going to come whether it's legislated or not—market forces are telling all providers that change is afoot. Frankly, if you talk to them honestly and behind closed doors, most of them will tell you change is absolutely required." Daniel Zismer, SPH Professor

"Federal health reform is focused in large part on access, but what are we doing about the cost and delivery challenges we face? That's what we're focused on at the state level." Carol Backstrom, Assistant to the Commissioner for Health Reform, Minnesota Department of Health