Medco’s CEO on National Healthcare Reform

David Snow, the Medco CEO, presented his blueprint for healthcare reform today. You can read it here. My notes from reviewing it are:

• We’re paying twice as much per person (~$7,000) as other countries with little incremental value. To get back in balance, we need to reduce costs by 50% or $1 trillion per year.
• 3 rules for reform:
  • “First, keep it simple – in business, complex solutions always fail.” [good advice…difficult to do with politics and government involved]
  • Incremental, evolutionary change is more accepted than revolutionary change. [yes…but it will take a lot longer]
  • Government and private sector’s roles have to be clear:
    • Government – promulgate and regulate.
    • Private – operate and innovate.
• “Setting policy around life-and-death decisions is, and should remain, the province of the public sector.” [what politician or elected official wants to determine the value of a life]
• Five suggestions (which create $1 trillion in savings per year):
  • Wiring healthcare
  • Fixing Medicare’s financial fundamentals
  • Eliminating medical liability and defensive medicine
  • Increasing compliance and reducing errors
  • Promoting healthy lifestyles
• “In an era when preschoolers use the Internet to chat with friends half a world away, it is inexcusable that doctors write prescriptions – in Latin – that patients need to take to another professional in a process fraught with countless opportunities for error.”
• “30% of Medicare spending today, roughly $130 billion, relates to healthcare costs incurred by patients in their last year of life – often where there is no hope for recovery or improvement in quality of life.”
• He makes some good points about the need for government involvement in changing attitudes around wellness comparing it to the changes around forest fires and seatbelt safety.
• “When our political discourse is limited to ‘who pays the bill’ instead of ‘the bill is too high,’ and fails to address root-cause problems, that isn’t health care reform.”