LEE BURDICK

Healthcare Planning in a Time of Great Uncertainty   Malcolm Gladwell in his recent book described The Tipping Point as “that one dramatic moment…when everything can change all at once.”  Undoubtedly, our healthcare system is at such a tipping point.  Recent legislative and regulatory changes have introduced uncertainty into the entire industry.  That uncertainty seems to suggest that if one more grain of sand falls, it could tip the industry that constitutes 17 percent of the U.S. economy into fundamental change in one direction or another, for better or worse.   In the case of healthcare, if the sand propels momentum to one side it could result in formidable, additional government intervention.  One point is clear from this last year: The public and its elected government believe the U.S. healthcare system is broken.  According to some, we spend more on healthcare services than any other country in the world, and yet we are 29th as far as beneficial outcomes.  Despite its preexisting condition, the healthcare industry continued its downward spiral as millions of Americans have become unemployed and uninsured, significantly diminishing the risk pool and driving up premiums.  Simultaneously, the growing uninsured too often flock to emergency rooms for treatment of minor and sometimes preventable diseases, thus securing care in the most expensive way possible.  The health plans’ response – seeking premium rate increases in a recessionary economy – has been met with disbelief and anger, thus inciting the possibility of further government intervention and regulation of the industry.

Obviously, in 2010, the government signaled its willingness to intervene in this expansive industry with the adoption of the Affordable Care and Coverage Act.  Although the bill represented legislative sausage of the highest order – and without regard to partisan affiliation or beliefs, something with which no one was

happy – it does more than signal the government’s intention to intervene where it feels that a particular industry is no longer serving the public interest and need: Last year’s reform bill is a bellwether for the promise of additional intervention if the market continues to fail to self-correct.

In contrast, if the healthcare industry were to self-correct by responding to market demands and the public interest in an impactful way, the final grain of sand could force the tipping point the other way.  Conceivably,

if all industry segments realign in a way that serves the public interest and need, it could avoid any additional government intervention or regulation.  In other words, the public interest must be marshaled in a way that sends clear market signals about what consumers will and will not accept in the provision of and payment for healthcare services.  What consumers and purchasers want is better quality care resulting in better outcomes leading to better economics.

What consumers want is to save lives and to save money, too.  The great thing is both of those objectives are within our power to achieve.  With a purposeful mission, a reaffirmed strategic approach, and a new educational effort, CHCC is poised to have a real and significant impact on changing the healthcare industry.  It starts by augmenting the voice of large purchasers and consumers in California, and then directing that voice to educate and influence doctors and hospitals to adopt uniform quality measurement and reporting standards and to make available service and cost information so that consumers can make informed choices about the quality of their healthcare.  Such consumer-driven solutions can go a long way toward improving the significant deficiencies in the current system without the need for additional government regulation.

CHCC is founded on a belief in the power that education has to support informed choices that result in better and longer lives.  CHCC believes in the power of positive change.  Please join us in this very important work.