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Have-It-All Health Care? Not Quite

“We offer service that is good, fast and inexpensive … but you can only pick two of the three.”

While it’s a popular saying among professional service providers and greasy spoon chefs, it accurately speaks to three elements of service that for many industries simply can’t be executed simultaneously.

A similar theory was discussed during a recent LEAD San Diego IMPACT class that focused on the hot topic of health care.

Tom Gehring, executive director & CEO of San Diego County Medical Society, gave the cohort a heavy dose of reality as it relates to the future of health care and the impact of the Affordable Care Act.

One of his examples related to the “pick two” theory. He explained that improving the cost of care, increasing quality of care and improving patients’ access to care can’t happen simultaneously. You can improve access and quality, but that’s going to increase the price. You can increase access and decrease cost, but quality will suffer.

However, these are three basic elements health care reform set out to improve. How well the Affordable Care Act addresses those issues is still up for debate, but the resounding theme the cohort heard throughout the day, was reform isn’t over. The Affordable Care Act isn’t the magic bullet to solve all our problems.

“Health care needed to be reformed. Health care still needs to be reformed,” said Mike Murphy, president and CEO of Sharp HealthCare. “Health care has not been solved.”

The session’s dialogue was data heavy and covered issues ranging from end of life care and health insurance exchanges to the importance of community health centers and the unsustainable nature of Medicare. Some of the mind-boggling statistics shared by the day’s presenters included:

  • 18 percent of the U.S. population doesn’t have health insurance and unemployment contributes to this figure.
  • Medicare is projected to be bankrupt in 2024.
  • In addition to cutting reimbursements to medical providers, the government will also make cuts on payments to medical schools, meaning there may be less physicians, while the number of patients accessing care will increase.
  • On average, today’s Medicare patient contributed $200,000 toward Medicare during their working years, but will consume $350,000 in care.
  • 60 to 70 percent of health care costs are spent on roughly 10 percent of the population.
  • 45 percent of the U.S. population has a chronic condition.

But Gehring reminded the cohort this session wasn’t all about doom and gloom, but rather awareness. By understanding the implications these decisions have on small businesses, large medical providers and low-income members of our community, we’re better equipped to address the needs of our region.

It’s critical for all of us to stay informed and look at the issue from a variety of viewpoints. Solving the health care conundrum will require not just the focus of the health care community and politicians, but all citizens.


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