Health Care CEOs Push for Systematic Reform of Health Care

The New America Foundation has formed a coalition of health care leaders to accelerate the pace of national health care reform efforts and to create a system of care that improves quality, enhances access and reduces costs.

"Health reform is so important we have to have a profound sense of urgency -- we cannot wait," said Len Nichols, Ph.D., director of the health policy program for New America Foundation during a Dec. 11 press briefing here announcing formation of the coalition. "We cannot reform our health care system unless we change business as usual."

The coalition, known as Health CEOs for Health Reform, comprises the heads of six major health providers from across the country, including Blue Shield of California, Catholic Healthcare West in San Francisco, Virginia Mason Medical Center in Seattle, Denver Health, the Billings (Mont.) Clinic, and Global Human Health, a division of Merck & Co. Inc.

Each of the coalition members supports health care transformation through fundamental reform of the nation's health care delivery and payment systems. Members also recognize the importance of primary care and the patient-centered medical home in any national health care reform effort.

"It is time for hospitals and physicians to address the reality that health care costs too much and our current ways of financing and delivering health care are outdated," said Lloyd Dean, president and CEO of Catholic Healthcare West, the eighth largest hospital system in the nation and the largest nonprofit hospital provider in California.

Patricia Gabow, M.D., CEO of Denver Health, called for the elimination of the current fee-for-service payment model, saying, "if you have a model that pays for doing more, people will do more."

"We need a payment model that will remove the enormous health care complexities that add cost as well as confusion for our patients and providers," said Gabow, who participated in the press briefing through a video hookup in Denver. "We need a payment model that provides the appropriate incentives to doing care, which provides real value to our patients."

Gabow also called for the creation of integrated health care models where "primary care is valued and utilized and where care is coordinated across the continuum of the patient's life and across the continuum of their disease."

According to Gabow, the U.S. government should pursue a cohesive and rational health care policy that defines a floor of guaranteed coverage as well as a ceiling that caps benefits. "We have to be clear about those things that we will not pay for," she said.

There is an unmistakable link between the nation's dysfunctional health care system and the current economic situation, said Gabow. "In part because of our dysfunctional health care system, American corporations are not as competitive as they could be in the global marketplace. Every corporation, large and small, has enormous health care expenses. All of us are feeling it in our pocketbooks."

"Some would say that given the state of our economy, we cannot afford health care reform," said Gary Kaplan, M.D., chair and CEO of the Virginia Mason Medical Center. "But I think now, increasingly, given the state of our economy, we cannot afford not to have health care reform. It is clear to all of us we have a crisis. We have a crisis in coverage, affordability and quality."

For example, the United States spends 16 to 17 percent of its gross domestic product on health care, but it ranks 29th in infant mortality, 48th in life expectancy, and 19 out of 19 in preventable deaths among industrialized nations, said Kaplan.

The coalition members agreed that reforming the nation's health care system will require compromises on the part of all stakeholders.

"Achieving coverage for all will require each of us to change the way we do business with regard to health plans," said Bruce Bodaken, chair and CEO of Blue Shield of California. "That means giving up the right to pick and choose our customers based on how healthy they are."