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Panel Detail:

Wednesday, April 29, 2009
9:30 AM - 10:45 AM

Health-Care Reform: Once More Into the Breach

Moderator:

Margaret Anderson, Chief Operating Officer, FasterCures / The Center for Accelerating Medical Solutions

Panelists from across the health-care industry favor universal access to care for all Americans, and decreasing costs will be big part of the equation.

The experts discussed the current and future impact of universal coverage and decreasing health-care costs by changing the delivery and prevention systems for chronic care. All panelists — representing insurance companies, advocacy groups and academics — supported universal coverage for the currently 46 million uninsured Americans.

Kenneth Thorpe of the Partnership to Fight Chronic Disease said the average cost of coverage for a family is about $12,000. The fundamental challenge of requiring everyone to have health insurance is affordability, he said. The estimated cost of covering the uninsured for the next 10 years is $1.5 trillion to $1.8 trillion.

Private insurance companies generally are not in favor of a public plan for the uninsured. Samuel Nussbaum of Wellpoint Inc. said such a plan likely would be based on current Medicare reimbursement rates, which are 20 percent less than those of private insurance. Today, the cost of Medicare's underpayments is passed on through private insurance.

Nussbaum, who leads one of the largest insurance companies at more than 35 million members, said 5 percent of Wellpoint′s members are responsible for 55 percent of reimbursement costs, so addressing those high-risk members is key to lowering costs. Nussbaum said the focus should be on prevention and wellness, better management of chronic care and promoting evidence-based medicine.

Wellpoint has achieved cost reductions by actively engaging consumers at home and working to prevent chronic illnesses, Nussbaum said. This includes encouraging inexpensive or free access to preventive measures such as blood pressure drugs and glucose testing for diabetes.

Commenting on high readmission rates of Medicare patients and the inefficiencies of the health-care system, Nussbaum said, "(Currently) someone′s inefficiencies are someone else's revenues." Addressing those issues requires aligning payments with outcome and changing the incentives of the health-care system, he said.

Chris Singer of the Pharmaceutical Research and Manufacturers of America said employers — large ones especially — should get behind the effort to reduce chronic diseases, which account for the bulk of health-care costs. The indirect costs of chronic illnesses to employers dwarf the direct costs to the health-care system, Singer said. These savings flow directly to the bottom line of the company, which benefits from increased worker productivity.

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