Well, it’s hard to do any “real-time” blogging with no plug for my laptop and no Internet access. I’m glad I actually began to try Twitter the other day. Here were the quick Twitter updates that I threw out there. To see all the “tweets” about the conference, you can go here (#whcc09).
- Information transparency is a waste of time if you don’t have choices. #whcc0927 minutes ago from txt
- Audience smiled less, gets less sleep, and less happy via gallup well-being survey done before event. #whcc0931 minutes ago from txt
- India $14 pmpy hc costs. #whcc09about 1 hour ago from txt
- Consumer reports rolling out safety and effectiveness comparisons to site tonight. Could be big deal and big first step. #whcc09 about 1 hour ago from txt
- #whcc09 highest selection on data to disclose is providing information on comparing mds (via audience poll). about 1 hour ago from txt
- Are consumers really willing to trade convenience for savings and broader coverage? Not real til it affects me. about 1 hour ago from txt
- #whcc09 healthcare is either engine for growth or anchor about 2 hours ago from txt
- #whcc09 ceo of kelly svcs says surveys show that greatest issue to starting company is access to hc about 2 hours ago from txt
- #whcc09 – ceo of wpt just said they sold nextrx to esrx as a way to lower costs. True in economy of scale perspective. What about coor …about 2 hours ago from txt
- #whcc09 only 10% of audience believe costs will be managed with legislation in 10 years. About 50% skeptical. about 2 hours ago from txt
- #whcc09 – reform w/o public plan an option if meet admin’s 8 objectives. about 3 hours ago from txt
- #whcc09 – MA connector has 80% of purchases online in under 25 minutes. Will broker model die? about 3 hours ago from txt
- #whcc09 person from MA connector – waste is someone else’s income – one challenge. Their trend is only 5%. Not bad. about 3 hours ago from txt
- #whcc09 bs of ca ceo – hc is a right. Can’t achieve coverage w/o controlling costs. Involve constituents more often. about 3 hours ago from txt
- #whcc09 good speaker from administration…laid out principles…no secret sauce…costs, quality, coverage about 3 hours ago from txt
These are my notes from the sessions. As time allows, I will work on some “stories”, but I thought I would share this.
Dr. Hughes from the Obama administration:
- HC costs are “crushing the budgets” of families and government
- Businesses finding it difficult to maintain coverage and be competitive internationally
- HC reform not just a moral imperative but an economic imperative (Obama says)
- Not whether every American deserves coverage but how we get there
How we get there
- Expand coverage
- Prevention and expansion of public health
- Very similar findings
- Affordable, high-quality coverage
- CHIP plan
American Recovery and XXX Act
Billions for research and other health priorities
- $19B to modernize system w/ HIT
- $1.1B comparative effectiveness
- $1B Prevention
- $2B Community Health Centers
- $500M for health workforce training and education
$87B to states for Medicaid and CHIP
HC tax cut of 65% for COBRA
$630B healthcare reserve fund for next 10 years
- No written plan…approaching with open mind to collaboration
President has endorsed 8 principles
- Protect family health
- Quality and safety
- Choice of MDs
- No pre-existing conditions
- End LT health cost growth for business
Bruce Bodaken – CEO of BS California
- Lessons learned from failed CA experiment
- Healthcare is a right (can’t turn a blind eye)
- Can’t achieve coverage w/o controlling costs
- Been working on CA legislation since 2002
- Need to touch base w/ constituents more often
- Need unions and business in lock-step
- May not want to take this all on at once [big bang vs. incrementalism]
- Can’t be globally competitive w/o addressing cost issue
- The right time to see this happen…”capture the moment”
- Change happens when things are up in the air
John Kingsdale – MA Health Connector
- Moral challenge that the country has to win
- Passed 198-2 in MA (across both houses)
Bit of genius to how they did it
- Bit off what they could chew
- Almost universal (2.6% uninsured)
- Universal insurance in Europe is closer to 1% uninsured
- Costs no more worse than CA and other places
- Didn’t worsen costs (5% annual trend)
- Didn’t do radical attack on costs…health care reform 2
- Pay ~600% more than industrialized countries for administration of health
- Pay ~300% more per day in hospital than other countries
- “Waste is someone else’s income”
- Moving away from fee for service model
How does the federal government do it in depth of recession?
- Premium increases still going up 10% while in recession / depression…how is that possible.
- Educate and inform buyer
- Put forth high value option
- Facilitate comparison for “shopping”
Connector can create a modern way to distribute health insurance…but this will threaten some of the existing players [i.e., brokers]
- 80% of their purchases are online in 20-25 minutes
Need for bi-partisan support. What’s president’s perspective – important or will he ram it through?
- Wants bi-partisan support.
- President will do what he has to do to get it passed.
One of the big elements of discussion is having a big public plan. Does it drive private plans out of business? Don’t take away from what people have. How does administration think it will play out?
- There are lots of good plans out there. Administration open to change / discussion. Plan doesn’t have to have public plan if it meets his 8 objectives.
- Having regulation w/ teeth important. Risk pool vs. head-to-head competition.
- Proposals for single payor in CA has failed multiple times.
- Need to do something other than putting ½ T business out of business
- Believe legislation will be passed
- 50% believe we will make marginal progress in next 10 years
- ~ 50% feel that cost mgmt unlikely
- 40/40/20 audience split btwn republican/democrat/independent
Second Session – Facilitated by Vanessa Fuhrmans (WSJ)
Health and Money
Angela Braly (WPT), Carl Camden (CEO of Kelly Services), and Mark McClellan (Brookings Institute)
Audience Poll: 42% believe individuals should pay the most for HC
Poll – what % of 17M adults going to MD will receive recommended course of care – 55%
CEO of Kelly Svcs
- 26% of workforce is “free agent”
- Expected to grow dramatically
- The group that produces the most new business start-ups
- US falling behind others in start-ups per 1,000
- Greatest impediment to starting business in US survey is access to HC
- Total costs of employment in US is driving move to offshore
- Question should we where jobs are growing vs. whether companies moving offshore
Audience Poll – Do you support reforms to the current payment system – 82% support major reform.
Audience Poll – Do you support reforms to the current delivery system – 84% support major reform.
Audience Poll – Would you still support if it affected access to your md, policies and cost – 67% yes. [this is a major variance from public response]
Angela – Private insurers will take proactive role in driving healthcare payment reform. Aligning reimbursement w/ outcomes may be the result. Compensating for prevention is important.
Mark – Lots of worry about comparative effectiveness being over simplified and mis-applied.
Mark – Need to focus on value in HC.
Angela was asked the “tough” question on why hasn’t healthcare reformed itself. I thought she had a great answer…”because people want convenience”. Members don’t want to have smaller networks or restricted access. They want everything, but at a lower cost. [Not a likely scenario.]