Healthcare Paradox: How The Industry Designed To Keep Us Well Is Also Making Our Planet – And Our Bodies – Sick (Forbes)

FORBES | Healthcare systems undertake a fundamental and challenging mission: keeping us healthy. But true health and wellbeing extends beyond hospital walls and examination rooms. Our bodies and minds, after all, can only be as healthy as the environments that nourish them.  

 It should go without saying then that what is bad for our environment — or planet — is equally bad for our health. Sure, loss of nature and biodiversity, upticks in pollution, and poor stewardship of our farmlands all have a direct impact on the natural, wondrous world around us. But our individual, human health is paying the price, too.

As a physician, I took an oath to do no harm. As a policy maker in Washington, I honored this oath through my focus on healthcare systems and global health. And now as a voice for nature and health in my role as Chair of the Global Board of The Nature Conservancy, I’ve begun to more closely examine that intersection between the health of our bodies and the health of our natural world, as well as the larger, more direct impact broader industries like the healthcare sector are having on our environment.

Read more at Forbes: https://www.forbes.com/sites/billfrist/2023/01/30/healthcare-paradox-how-the-industry-designed-to-keep-us-well-is-also-making-our-planet–and-our-bodies–sick/?sh=3df7c20c35d7

Reevaluating, Reimagining, And Reinventing Healthcare: Innovation In A Post-Pandemic World (Forbes)

FORBES | Since its onset, COVID-19 has been the focal point of recent healthcare innovation and advancement. Though the past couple of years have been filled with innumerable advancements of health technologies, much opportunity for reevaluating, reimagining, and reinventing the future of healthcare remains. The next two years will set the scope for what is to come.

As our world successfully transitions from a pandemic to endemic stage, the landscape of healthcare innovation is wide-open for disruption, as health, wellness, and healthcare are taken more fundamentally into the digital age. Advancing technology will be the vigorous driver behind a much needed refocusing of healthcare delivery to put the patient experience and navigation of health services back where it belongs front and center.

What we can expect—at least in the near-term future—is more digital transformation, more cloud, more integration, more automation, and overall a more coherent, consistent, and comprehensive delivery of healthcare.

Though the endless number of possibilities are inspiring, here are six areas where I foresee the most disruption occurring:

Read the full article here: https://www.forbes.com/sites/billfrist/2022/05/04/reevaluating-reimaging-and-reinventing-healthcare-innovation-in-a-post-pandemic-world/?sh=22feaffd1bc8

Premium Support is the Only Way to Fix America’s Medicare Mess

(The Week, March 27, 2012)

By Bill Frist, M.D.

To save Medicare — and rein in our national debt — we must transform the entitlement program into a defined-contribution system

Nothing is scarier than losing your health.

A close second, however, is getting sick and not being able to afford the care you need. For seniors, Medicare has been the entitlement program that for 47 years has dependably provided health security and peace of mind.

But today, demographics are shifting. Fewer workers are contributing to the pay-as-you-go system that by 2030 will cover double the number of beneficiaries it does now. Those reaching 65 this year, on average, will take out in services more than twice what they paid in over their lifetime. That is simply unsustainable. Medicare cannot last as currently configured.

Absent real changes, Medicare will be unable to meet the needs of seniors in the future.

And looming behind all this is our nation’s debt, skyrocketing on autopilot from $15 trillion today to $22 trillion in eight years. The higher the debt, the slower our economy grows, and the fewer jobs are created. Though a lot of people think Social Security is the culprit, it is not. As a percentage of GDP, it is our two government health programs, Medicare and Medicaid, which, left unchecked, will disproportionately balloon over the next 50 years.

For these reasons, the single most important reform that our next president must address is Medicare modernization.

Absent real changes, Medicare will be unable to meet the needs of seniors in the future.

This week marks the two-year anniversary of the President Obama’s health reform initiative. But that law did little to reform Medicare. Instead, it primarily addressed an entirely different issue, increasing access and expanding Medicaid so that one out of every four Americans will be on Medicaid in 36 months. Structurally, President Obama did not change Medicare at all.

If demographics, determined years in advance, define the impending bankruptcy of Medicare, why haven’t our elected leaders acted? Well, in fact, both President Clinton and President Obama, under mandates by Congress, appointed high-profile presidential commissions to address the issue of entitlement reform and Medicare modernization.

The irony is that both bipartisan commissions, one in 1998 and the other in 2010, demonstrated majority support for the exact same type of fundamental reform for Medicare, a plan that maximized security for our seniors, choice for the individual, and longterm sustainability of the program.

It’s called premium support. Here is how it would work:

When you become eligible for Medicare at 65, you choose a health plan from a menu of integrated private plans that all cover the basic benefit package provided under traditional Medicare today. They can vary in depth and scope of additional coverage. Or you can choose to keep traditional Medicare instead of choosing one of the more modern plans. It’s your choice. All the plans and the exchange system through which they are selected are regulated by the federal government to guarantee security, fairness, and accountability for the individual and a level playing field for the plans.

Your premium for the coverage will be paid partly by the government (known as a defined contribution or premium support). For example, hypothetically, this year the government might pay $8,000, and you pony up a supplementary sum — the total would depend on the additional benefits of the plan you selected. Your personal contribution would be means-tested, with more aggressive subsidies paid for those without resources to afford the basic coverage. The premium support level would be adjusted by income, geography, and health status. You would be able to afford it.

Is such a transformation of Medicare risky? Not really.

The government has a whole lot of experience successfully managing such an exchange, transparently ensuring its equity and value. It has been doing so with the FEHBP (Federal Employees Health Benefit Plan) for the past 52 years. This system has insured all federal employees, currently covering 9 million people, including me when I was a senator — making it the largest employer-sponsored group health insurance program in the world.

The advantages of premium support are many.

Each senior is empowered with a choice of comprehensive plans, similar to what each member of Congress enjoys. Plans can rapidly adopt improved innovations in benefits and coverage rather than wait years for Washington to pass another law. And increased price transparency demanded by active consumers interested in making a value-based choice of plans will empower 50 million Americans to powerfully participate in reducing waste, continually squeezing the fat out of the system.

Premium support would reduce total spending by stimulating price competition among plans (just as has been observed with the Medicare prescription drug coverage structure created in 2003). Beneficiaries become more cost conscious in choosing a plan that best suits their needs.

No longer would doctor and hospital reimbursement be determined by Washington-based price fixing (and arbitrary, blunt, across-the-board cuts) but rather, by value to beneficiaries. No longer will federal centralized pricing of 155,000 service codes based on episodic and unpredictable review be necessary. A side benefit would be a reduction in the costly and distorting power of lobbyists and Washington-based special interests who thrive on managing this centralized price setting to their advantage.

Premium support makes Medicare sustainable longterm, and goes a long way toward reversing the debt and entitlement problems that threaten America’s future.

And what are the naysayers worried about? First, they say providing seniors with more choice is just too confusing. But seniors can keep what they have in traditional Medicare if they want. Second, they argue premium support simply shifts costs and does nothing to reduce the overall price of care. But aligning reimbursement with value and quality rather than quantity will minimize this shift.

The premium support concept is neither novel nor new. Initially proposed in a bipartisan spirit by two congressmen in 1983, endorsed by two prominent health policy economists in 1994, supported by a majority of both of the last two presidential commissions, and more recently proposed by members of both political parties in Congress, premium support is the leading solution to achieve Medicare modernization for seniors and fiscal solvency for our country.


Dr. William H. Frist is a nationally acclaimed heart transplant surgeon, former U.S. Senate Majority Leader, the chairman of Hope Through Healing Hands and Tennessee SCORE, professor of surgery, and author of six books.

 

This article was originally featured in The Week http://theweek.com/article/index/226065/premium-support-is-the-only-way-to-fix-americas-medicare-mess