As a congenital skeptic, I’m having a hard time processing all the optimistic talk around health care reform coming out of the MGMA conference. While acknowledging the many things that are wrong with the system today and the fact that one powerful force or another is ready to block nearly every proposal for change, speaker after speaker has professed a belief that we as a nation can come together—and, in fact, we are coming together even now—to fix what needs fixing.
Today’s self-declared optimist (at least the first of the day; it’s early yet) is William Jessee, MGMA president and CEO. “I’m bullish on America! I’m all fired up!” he boomed in a blast of enthusiasm not universally shared by conference attendees at 7:30 in the morning.
Jessee said there are five “outstanding attributes” to address in health care today, none of which should surprise anybody:
1) The system is fragmented; primary care physicians are too few and specialists are ever more specialized, patients shuttle between providers but their records don’t follow; hospitals don’t communicate with each other or with other providers.
2) Costs are too high.
3) The system is inequitable.
4) Quality is spotty.
5) The payment system is “perverse.”
But, “we’re having more discourse and dialogue” about possible solutions, he claimed, and “much of it is even civil.”
For example, on the payment front, he said consensus seems to be building that reimbursing for more services is “irrational.” Instead, the system should reward results, institute “sensible” spending caps, strip out “our ridiculous” administrative waste and eliminate overuse.
Jessee cited real-life examples of health care systems around the country that are test-driving possible solutions for the field’s big challenges, often with amazing results and often in partnership with payers.
The overarching question being asked, he said, is can we afford to change the system? Improving quality, getting people the right kind of care when they need it, encouraging behavior changes and so on will cost money upfront, but in the long run will produce savings, he insisted. “The real question is, can we afford not to do it?”
Jessee repeated Winston Churchill’s well-known quip that Americans will always do the right thing—after they’ve tried everything else. “Well,” he said, “we’ve done everything else. Now it’s time to do the right thing.”
Bill Santamour is H&HN's managing editor blogging live from MGMA 2009 Conference.
