Highlights from New Health Insurance Business Models for a Post-Reform World, AIS’s conference held last week in Washington, D.C. Thirty-one industry experts participated in the two-day event on compelling bottom-line issues for health business leaders — from exchanges to dual eligibles to new benefit designs to ACOs and medical homes … to how the elections will reshape health reform law and regulation.
Declaring the transformation under way in the U.S. health care system as comparable to the creation of the nation’s monetary system in 1913, the start of Social Security in the 1930s and the advent of Medicare and Medicaid in the 1960s, former Senate Majority Leader Tom Daschle (D-S.D.) presented attendees at AIS’s Health Business Roundtable on Oct. 4-5 with an overview of what is at stake with the implementation of the Affordable Care Act.
Daschle, in delivering the Keynote Address at the Washington, D.C., conference, said the upside-down structure of the health care system and its inefficiencies demand changing. The system, which he said is not really a system as much as a health care marketplace, has so many problems that members of both major political parties recognize the need for significant reforms.
“There are many areas for substantial common ground,” Daschle said, pointing to the three major plagues in the system now: access to health care, the cost of care and the quality of care.
On access alone, he noted there are some 50 million Americans without health insurance, which results in 26,000 people dying every year because they don’t have coverage, he said, citing recent data.
With respect to costs, Daschle said the U.S. will spend $35 trillion on health care over the next 10 years, gobbling up more and more of the U.S. Gross Domestic Product (GDP) as each year goes by. To illustrate the drastic cost inflation, he said that when he was born in 1947, health care costs ran at 4% of GDP, but they rose to 8% of GDP when his children were born, 16% when his grandchildren arrived and will be double that, at 32%, if he were to see great grandchildren in his lifetime. “It is unsustainable,” Daschle said.
On quality, he said the U.S. move from 11th to 42nd in the world in life expectancy shows “we’ve got a quality issue that is only getting worse.”
To transform health care, Daschle said there are many substantial changes necessary, including making all aspects of the system transparent, continuing a move away from fee-for-service care delivery and installing a modern, paperless information technology business model.
For the near term, he noted numerous challenges to the ACA’s implementation, with the most obvious the presidential and congressional elections next month. He also cited pending court decisions on various issues, policy battles and budget conflicts tied to “the fiscal cliff” that could occur at the end of the year, and ongoing debates on deficit reduction.
Hear insights from Daschle and other top experts on today’s biggest challenges and creative solutions for health care leaders. The on-demand recording of New Health Insurance Business Models for a Post-Reform World will provide tips and tactics to help your organization thrive in the tumultuous days ahead, even if you couldn’t make it to DC for the Roundtable event. Click here for more information.
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