Against the backdrop of fierce political debate on health care reform in Washington, D.C., the Cambia Grove and the Bipartisan Policy Center collaborated on an engaging event July 25, 2017 that focused on the role policy and technology play in designing a more consumer-centric, economically sustainable health care system.
A packed house and dozens of online viewers welcomed national health care policy experts, former U.S. Senate Majority Leader Bill Frist, MD, and former Acting CMS Administrator Andy Slavitt for a compelling conversation moderated by Health Intelligence Partners CEO and Cambia Health Solutions Board member Jan Berger.
The event was part of BPC’s discussion series, which serves as a resource to policymakers to develop effective and politically viable solutions to our nation’s greatest challenges. Recently, BPC’s group of policy experts has been traveling across the country for its Future of Health Care project, convening leaders in the health care sector in an effort to support policymakers and business leaders as they consider how health reform impacts their activities and the people they serve.
Our Current National Health Care Debate
Senator Frist placed the debate happening that week around health care reform in context, connecting it to earlier debates that surrounded health care legislation. He suggested that the long-term trend consists of expanding access to health care, and that he expects that trend to continue.
Administrator Slavitt picked up that thread. He said that in the more recent debates around health care legislation, while Democrats typically talk about increasing coverage, Republicans point to the need to control cost. “I would observe that what we have today is a set of policies … that really don’t achieve either outcome,” said Slavitt.
“When we’re having this debate [around extending health care for more people] again in the 2020s, which we will, what will we want to be having it about, and how will we be want to be having it, and what do we need to be doing now,” asked Slavitt.
“The great news is, we don’t have to waste those ten years, because the states have so much they can accomplish, and I think they can show the way for the federal government when we take this up again,” said Slavitt.
Frist mentioned how as Majority Leader, collaboration across the aisle was considered invaluable.
Frist also mentioned that by reducing the threshold needed to pass the ACA, that helped introduce a type of partisanship that we still see influencing the health care debate in Washington, D.C.
“If you keep the 60-vote threshold, you need bipartisanship,” said Frist. “We can return to that.”
Slavitt argued that regardless of the outcome of the Senate Republican health care bill that was being debated that week, there are still opportunities to implement technical fixes for issues with legislation that has already been passed into law. He said that many of the issues identified fairly early on with the ACA—competitive and stable markets among them—were left uncorrected, in part because of an inability by both Democrats and Republicans to muster the political will to work together to do that.
Both Frist and Slavitt then re-emphasized the need for bipartisanship on behalf of the whole country. “[The American people] so desperately want [elected officials] to come to D.C. that are not [going] to make them table stakes in a poker game,” said Slavitt.
“America’s problems are not with 67-year-old joggers with two Fitbits,” said Slavitt. He said the real issues will require us to better focus innovations in areas with greater impact, not just the worried well.
“If we invest it where we are spending an awful lot of money for not a lot of good outcome, frankly with people who are older, poorer and sicker … I can tell you that if everybody in the country had access to the same health care experience I have, we would be just fine,” said Slavitt.
Slavitt also said very explicitly we charge each other too much for health care.
Slavitt also pointed to the need for health care to become more human. He emphasized that we should focus our efforts on uniting families and supporting and empowering the people who care for their loved ones, and that innovation in those areas is important because you need good technology and data to make that dream come true.
Frist said health care delivery has to change. “The way we do that is what Seattle sings in – empowerment of individuals through consumer engagement in a way that gives them the information and tools they need to shop wisely … Let them choose based on what is valuable to them.”
Frist also said individual entrepreneurs can be inspired through “challenges” (like the Alexa Diabetes Challenge) to develop new solutions and new delivery mechanisms that empower consumers and address the cost issue even without intervention from government.
Audience Q&A Highlights
On the focus of our health care system:
- “We underinvest in keeping people healthy, we underinvest in primary care, and we overinvest in having people show up once they’re past the point of treatment,” said Slavitt.
On meeting the demand for care:
- “We need to make sure that we don’t have such rigid [role] definitions that people can’t really practice up to what they’re licensed to practice, and that means doctors have to kind of turn over some of this traditional control to ancillary personnel,” said Frist.
On entrenched interests in health care:
- Frist said advocates and patients can connect with their elected officials. “Now millions of people can actually write [their elected representatives], and it can have an impact, bypassing the D.C. establishment,” said Frist. “Once we can work social media to [get to] true engagement, with the appropriate curation, you start bypassing many of these entrenched interests.”
On the question of whether or not health care is a right:
- Slavitt said that he believes there are some things we do have a right to—such as regular care and some financial protections. “[We need to] get to a language that unites us … around how we think about health care in a universal way,” he said.
- Frist also said the language around health care debate needs to change to support better understanding and public discourse. “The discussion [Is health care a right?] is a good one to have. Once you convert the words to a ‘responsibility’ discussion … it becomes [a much easier discussion].”
On end of life care:
- Frist said that the cost of care toward the life can be reduced by as much as half when the focus is on providing appropriate care—and that requires discussions about end of life treatment options and a focus on higher quality of care and increased patient satisfaction.
As we have watched the debate over health care continue since July 25, the presence at the Cambia Grove of these two health care policy leaders and public servants who are well-known for their tireless efforts to bring innovative change to our health care system was notable. Their willingness to connect with attendees and bring Pacific Northwest perspectives back into the national discussion was a reminder of the power of bipartisan debate and collaboration.
Not only was this a discussion on the future of health care, it was a call to action to look outside of Washington, D.C. on ways we can all facilitate health care transformation. More will come on that call to action in a future blog post.
Interested in seeing the whole event? You can find the video on the Cambia Grove YouTube channel.
Cambia's HealthChangers podcast series features an abridged version of the conversation. Find it below: