Mark Kelley
Henry Ford Medical Group C.E.O.

Mark Kelley

Mark A. Kelley, M.D., is executive vice president for Henry Ford Health System and chief executive officer of the Henry Ford Medical Group.

We Need A Time Out

The public debate has illuminated the realities of health care reform:

Universal coverage-details?--No one opposes the concept but concerns remain about the benefits design, administration, limits of coverage, "rationing" etc. Strangely, everyone ignores Medicare which has excellent, durable coverage.

Universal coverage-expensive--The soaring costs of the Massachusetts health plan are sobering. Cost savings from preventive services and better access take time-- but even that may be wishful thinking.

Political messages-confusing-- The White House has been promoting universal coverage while citing health care costs as a threat to the nation's economy. It is hard to reconcile these two concepts. If our current delivery system is such a mess, how does expanded coverage reduce cost?

Cost savings--elusive -The Congressional Budget Office will not book any immediate cost savings from proposed improvements in health care delivery. The CBO is right--these savings will take years. The inflationary curve can only be bent by redesigning systems of care and changing the payment incentives. This will not be easy but it is THE "game-changer".

Revenue source-taxes--Universal coverage cannot be achieved without new taxes. This has sent a torpedo into the bow of health reform. Now, every taxpayer is wondering why we should rush into universal coverage during a major recession.

The country is facing some hard questions. Are we serious about real change when we have not fixed Medicare? Do we have the will and the patience to implement fundamental reforms or are we content with "quick fix" political wins? Finally, is health care reform even possible with the current political process?

Members of Congress should declare a time out. The issues are clear but the solutions obscure. It is now time to go home and discuss these things with folks back home. I suspect most citizens want steady progress, not reckless speed.

By Mark Kelley  |  July 29, 2009; 1:37 PM ET  | Category:  Health Care Reform , Leadership Save & Share:  Send E-mail   Facebook   Twitter   Digg   Yahoo Buzz   Del.icio.us   StumbleUpon   Technorati  
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The system (or more accurately,the lack of one) is indeed the problem. Health care needs a rational economic model implemented by well-organized systems of care that deliver value. Such systems may be national or regional.

Congress must change the payment system to stimulate and reward this model. Such a bold stroke demands strong political will since the outcome will not realized for many years.

Universal coverage will require more providers and dollars but the cost need not be prohibitive. Within the current system lie many opportunities to improve efficiency and reduce waste.

A century ago, the industrial genius Henry Ford developed "LEAN" techniques. With steadfast determination, he perfected his manufacturing process to produce cars that were safe, reliable and affordable.

That is exactly that we need in health care.

Posted by: MarkKelleyMD | August 1, 2009 10:32 AM
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Dr. Kelley, you don't even touch on the system itself. To me the biggest obstacle is that if you really believe there are 45 million uninsured (I think its more like 10-12 million if you exclude illegal aliens, those who choose not to spend their $ on health insurance even though they can afford it, and those who opt out of their employers plan because they are young and healthy, etc.) and they theoretically begin to see doctors...how in the world could our system handle it currently given the primary care and nursing shortages? This is a more difficult issue.

Posted by: jke1 | July 30, 2009 8:38 AM
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