Dr. Elizabeth Teisberg asked a room full of business executives gathered Wednesday at Connecticut Business and Industry Association’s annual meeting to imagine a health care system that is results driven and physician led.
While the health care debate in this country and this state centers around insurance coverage and access, Teisberg, co-author of Redefining Health Care concluded, “It’s not about who pays, it’s about the structure of care.” She said if everyone was focused on improving people’s health outcomes, then everyone could afford to be in the system.
She said she’s not an advocate for one payment system—single-payer versus employer sponsored insurance plan—over another, however, in order to achieve equity and efficiency in the health care system everyone needs to be included.
As she sees it, if the medical delivery structure isn’t focused on value and measured outcomes, then it doesn’t matter who is paying.
“How we pay comes after how we do it,” she said.
She pointed out a Sept. 26 article from Bloomberg news where a coal company was paying for the best medical clinic in the country to perform surgeries for its employees and their families and was saving money doing it. According to the article, “The coal producer says it has found an unconventional way to cut health costs: Seek out the nation’s best care and give workers incentives to use it.”
“Altruism is not required to get this started,” Teisberg said. “If we just get the momentum going we can have a health care system that’s about health and care.”
Eric George, associate counsel for CBIA, said after listening to Teisberg’s speech Wednesday he agreed “this should not be a zero sum game.” He said rather than arguing about who pays “we should be looking to get more out of the system.”
Tom Swan, chairman of Health First Authority and executive director of Connecticut Citizens Action Group, said “throwing more money at our existing system would not result in the health care we want.” He said he agrees with a lot of what Teisberg had to say Wednesday, especially when she pointed out that in order to achieve equity and efficiency everyone needs to be in the system.
Some of the value elements, such as coordination of care across medical disciplines, is something Swan believes will be recommended by the Health First Authority in its report to the legislature due out at the end of December. He said there will also be a Primary Care Case Management pilot program as an alternative to Medicaid Managed Care model. He said many people are excited about PCCM because it centers around a primary care physician who is in charge of coordinating the care for its patients.
To learn more about PCCM visit the Connecticut Health Policy Project Web site.