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The Role of Academic Health Centers
in Health Care Reform
2006 Annual Meeting
San Antonio, Texas
Roundtable: What"s Broken in the System? What Needs to be Fixed?
James Guest, President, Consumers Union; Peter Wald, MD, PhD, Assistant Vice President for Wellness, USAA; Charles Kahn, MPH, President, Federation of American Hospitals; James Capretta, MA, Fellow, Ethics and Public Policy Center and Managing Director of Civic Enterprises, LLC
"The public's trust and confidence in physicians and health care institutions is critical."
Health leaders representing consumer, corporate, provider, and government interests raised problems with the health care system from these particular perspectives and suggested ways to improve and reform healthcare quality.
The public's trust and confidence in physicians and health care institutions is critical to the consumer/patient, according to Mr. Guest, who emphasized ways to maintain trust. People are overwhelmed by a sea of choices, and need help navigating their way through the health system. There is a need for information on the quality of hospitals and physicians to aid consumers in making decisions. Guest suggested a "Consumer Reports" for health.
From the perspective of businesses and employers, Wald noted the difficulty of decision-making in health care. Employees look to employers as proxies for decision-making. However, neither employers nor employees have enough information on what they are buying and its value. Wald emphasized that a major need from the health system is a way to change behavior and unhealthy lifestyles.
"The health system needs greater transparency."
The health care system has an insufficient response to chronic disease care. Coordination and systemization must exist in this area. There is also a lack of comprehensive, interoperable information technology. Kahn echoed the claim that the health system needs greater transparency-in errors, efficiency, and pricing, among other things. However, efficiency is still not very well defined, and should not be viewed as a silver bullet for the problems facing health care. Kahn voiced concern about a growing disconnect between physicians and hospitals. The specialty hospital movement is a symptom of this problem, and represents how economics have gone awry in the health care system.
Capretta raised a number of concerns about the U.S. health care system from the government's perspective. Fragmentation is the most serious problem, along with turbulence in the insurance market, the aging of the population, and a broken payment system, said Capretta. He suggested that the system might be improved by measuring the right things.
"Fragmentation is the most serious problem."