Leveraging Health

Life intervenes sometimes. I haven't had the chance to blog for the health-care reform panel in a month. However, during a layover en route from Washington, D.C., to Dartmouth (Hanover, N.H) to speak to Paul Gardent's class at the Tuck School of Business, I had the opportunity to again pick up laptop to commit my thoughts to... well, not to paper.

First, to play catch-up a bit. "How significant is the malpractice problem?" Very significant. The current situation certainly promotes defensive over-ordering of marginally indicated services. We need tort reform now!

"Taxing 'Cadillac' health plans: yes or no?" Yes. Taxing health-care benefits above a certain threshold should drive purchasers to find higher-value providers. For this to be successful, however, every plan must include a core set of high-value services (mostly preventive and catastrophic).

"Will cuts to Medicare Advantage hurt beneficiaries?" I honestly don't know.

And now, to the topic topmost in my mind this week: driving health-care value.

Sept 30 was an auspicious day for the Center for Health Value Innovation . I have the pleasure of serving on the Executive Board of Directors for this not-for-profit organization whose mission is to spread the message that innovations in health-care benefits design do, in fact, drive behavior change. Change which, in turn, drives down cost while enhancing health. Our merry little band of like-minded employers, payers, and providers launched the Center's first book, Leveraging Health, at the National Press Club in Washington, D.C. Authors include Cyndy Nayer, Jack Mahoney and Jan Berger. I had the pleasure of serving as emcee at the event. The book's a thin tome, and that's a good thing; an essential distillation of the major "levers" that move health-related behavior. It represents the stories of many of the founding members of the CHVI board. We learn a lot from each other and continue to innovate at our organizational homes. I bring up Leveraging Health at this time because I wish Congress would take our lessons to heart in crafting health-care reform legislation. Also to follow our lead in brevity.

Archimedes once said, "Give me a lever long enough and a fulcrum on which to place it, and I will move the world." This moment in American history is our fulcrum. However, I fear that as the days now grow shorter, so too, our lever to effect meaningful health-care reform shortens. This week began with news that the "public option" would appear to be dead (whew)! I hope that in Congress' haste to pass something, they do not lose sight of the true goal of health-care reform: aligning the incentives of all the actors in the health-care drama such that our ultimate outcome - a healthy U.S. population - emerges above the entrenched interests of those who would wish to see us remain mired in the sale of units of health-care delivery.

By Raymond J. Zastrow  |  October 1, 2009; 10:22 PM ET  | Category:  Health Care Reform , Health costs , Insurance , Medicare
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