The Future of Health [sick] The Future of Health [sick] Care or The Thoughts of a Care or The Thoughts of a

Grumpy Old ManGrumpy Old Man

THE FUTURE OF HEALTH THE FUTURE OF HEALTH CARECARE

THE FUTURE OF HEALTH THE FUTURE OF HEALTH CARECARE

Arthur Hoppe; “The Waiting Game”, 1980; Russell Bakers Book of

Humor in America:

(with apologies)

The Iron TriangleThe Iron Triangle

QUALITYACCESSCOST

Three Major IssuesThree Major Issues

ComplexityRole of government$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$

The future of health care?The future of health care?

Issue One“The future will not be resolved until we

fully grasp the complexity of the political, economic, technological, and sociological forces in the United States that are a part of health care.” Grumpy old man

It’s all connectedIt’s all connected

We eat 300 more calories a day than we did 25 years ago

We all weigh on average ten pounds more We have a serious epidemic of: - Obesity

- type 2 diabetes

- heart disease

- diet related cancers

It’s all connectedIt’s all connected

Chronic disease adds $250 Billion dollars/per year to health care cost

The generation being born now will have a shorter life span than their parents

One in three Americans born in 2000 will have type two diabetes.

Each individual winds up spending an additional $14 K/year for health care

It’s all connectedIt’s all connected

Federal Government spends $25 Billion a year in farm subsidies.

We subsidize corn, wheat, soy, rice and cotton Can you say fast food while you are drinking your

diet soda today! Results in a war between public health goals and

agriculture policies. (From a Bill Moyers interview with Michael Polan

on Bill Moyers Journal)

The future of health careThe future of health care

Issue two“The future will not be resolved until the

United States comes to a consensus on the role of government in our society.” Grumpy old man

Political Forces: Role of Political Forces: Role of GovernmentGovernment

Left Government is the

best option for the delivery of health care services.

Right Little or no

government involvement.

Private sector is the best means to delivery of health care services.

Sociological ForcesSociological Forces

Politics is the “art of compromise”Today the political arguments have become

theologicalTheology does not allow compromise

The Future of Health CareThe Future of Health Care

Issue ThreeHow do we deal with all the money in

system?

“ we were all making too much money” Hank Paulson in HBO’s Too Big to Fail

The Future of Health CareThe Future of Health Care

What do we mean by “health care”?Is health care a business/industry?Are we patients or are we consumers?Does competition reduce costs? How many

MRIs are enough?

Health Care Regulation?Health Care Regulation?

Do more with less!Role of State versus Federal?Role of Private versus Government?

QUESTIONS????? For the QUESTIONS????? For the ConferenceConference

Is there an inherent conflict of interest in entrusting much of the oversight of health care professionals to organizations that the professionals themselves control? What are the arguments for and against relying on private regulators as a part of the oversight process?

QUESTIONS???QUESTIONS???

DOES AMERICA NEED A SYSTEM OF UNIVERSAL HEALTH CARE COVERAGE? PRIVATE OR GOVERNMENT? HOW WOULD WE REGULATE IT?

QUESTIONS???QUESTIONS???

OVERALL, TO WHAT EXTENT DOES REGULATION IMPROVE HEALTH CARE IN AMERICA?

OVERALL, TO WHAT EXTENT DOES REGULATION CREATE INEFFICENCY AND INCREASE THE COST OF HEALTH CARE IN AMERICA?

““I am an old man and have known many I am an old man and have known many tragedies, but most of them never tragedies, but most of them never

happened.” Mark Twainhappened.” Mark Twain

Thank You!Thank You!