America’s Healthcare Crisis
Nothing brings the challenges facing our nation home like a visit to a crowded emergency room on a weekend night. Without insurance, many people turn to taxpayer-funded hospitals for primary care services, often arriving with chronic conditions brought on by poor diet and fitness, and exacerbated by a lack of early intervention. Meanwhile, businesses work hard to provide healthcare benefits and wellness programs to their employees, despite watching the cost of their insurance rise year over year and wondering what positive or negative changes the next election might bring.
Pearson Partners’ Q3 2012 Spotlight Series event discussed the current state of America’s healthcare system, as well as possible solutions presented by the four healthcare experts on our panel.
Our esteemed panel members included:
- James M. Greenwood, Chief Executive Officer, Concentra
- John B. McWhorter, III, President, Baylor University Medical Center at Dallas, and Senior Vice President, Baylor Healthcare System
- Dan Thomas, President & CEO, Provista
- John R. Thomas, Chief Executive Officer, MedSynergies
A Nation in Waiting
As the nation’s business leaders await the outcome of November’s presidential and congressional elections, one of their primary concerns is the cost of healthcare benefits for their employees. The Affordable Care Act, championed by President Obama, is poised to fundamentally change many aspects of the healthcare system, but hundreds of thousands of pages of regulations have yet to be written, leaving business leaders doubly uncertain of what changes or challenges may lie around the bend.
Most people, regardless of political affiliation, can agree that while America has excellent healthcare, our current system is too expensive and has many flaws. Of the roughly one million physicians in our country, only one-third are primary care providers, thanks to fewer medical school graduates choosing primary care over higher-paying specialties. At the same time, almost 10,000 people age into Medicare coverage each day, creating an imbalance between the demand for primary care medical services and the dwindling supply of available physicians.
Without regular medical care, many people don’t receive the screening and prevention services that are critical to managing their health and preventing costly health problems. Because the majority of uninsured people relying on public hospital emergency rooms for primary care are under the age of 18 or over 65, the burden of paying for their care falls to taxpayers.
At the same time, healthcare is plagued by redundancy, ambiguity and waste, all of which contribute to rising costs. Chronic health conditions related to poor diet and lack of exercise also drive up costs, as do lack of coordination between care providers and a system in which provider reimbursement is based on the number of procedures performed, often resulting in unnecessary procedures.
The constantly changing regulatory environment makes it difficult for business leaders to plan ahead. Because the economic policy regarding payment for healthcare services is constantly changing, hospital administrators have difficulty budgeting for future needs. Meanwhile, business leaders in all industries continue to see their healthcare insurance costs rise.
Our panelists agree that one key to a successful healthcare system is ensuring access to primary care physicians. Currently, many physicians decline primary care careers for financial reasons: The cost of running a practice, combined with low reimbursement rates, makes it difficult to operate a lucrative practice in primary care without seeing a high volume of patients. However, seeing more patients in less time reduces the opportunity to provide the time-intensive care necessary to effectively manage each patient’s health. As a generation of aging baby boomers begins to require higher levels of care, one idea is to encourage more doctors to practice primary care by ensuring that they will receive adequate compensation.
Another way to reduce healthcare costs is by making people accountable for their own health, partially by encouraging changes in diet and fitness. Employers can invest in companywide health improvement initiatives that pay off with healthier, more productive employees who require less expensive care, reducing insurance premiums. However, because the majority of people filling hospital emergency rooms are the very young and elderly—rather than the ages in between that compose most of the work force—it’s also important to create an overall culture of health by reaching low-income families through the schools and ensuring access to preventive care for the unemployed and chronically ill who have no safety net.
Although initiatives are under way to contain costs, reduce redundancy, and improve the quality of care through advances such as electronic medical records, America’s healthcare system has a long way to go before noticeable improvements in cost and quality are attained.