National Center for Policy Analysis Making Ideas Change the World Solving America’s Health Care Crisis Presentation to The National Congress on Health.

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Presentation transcript:

National Center for Policy Analysis Making Ideas Change the World Solving America’s Health Care Crisis Presentation to The National Congress on Health Reform John C. Goodman September 22, 2008 National Center for Policy Analysis Making Ideas Change the World

National Center for Policy Analysis Making Ideas Change the World Problems Cost Cost Quality Quality Access Access

National Center for Policy Analysis Making Ideas Change the World Thinking About Health Care Queen of Hearts Seven Dwarfs Little Red Riding Hood

National Center for Policy Analysis Making Ideas Change the World Problems Cost Cost

National Center for Policy Analysis Making Ideas Change the World

National Center for Policy Analysis Making Ideas Change the World Medicare and Medicaid as a Percent of Federal Budget Source: Congressional Budget Office. Today

National Center for Policy Analysis Making Ideas Change the World Marginal Federal Income Tax Rates Needed to Fund Current Federal Programs in 2050 Source: Congressional Budget Office. Upper-IncomeMiddle-Income

National Center for Policy Analysis Making Ideas Change the World Illusory Solution One-Time Cost Reduction

National Center for Policy Analysis Making Ideas Change the World Health Care Spending Time $ One Time Policy Change Old Spending Path New Spending Path

National Center for Policy Analysis Making Ideas Change the World Shifting Costs Illusory Solution

National Center for Policy Analysis Making Ideas Change the World Ratio of Physician Income to Average Worker Income Source: Uwe E. Reinhardt, Peter S. Hussey and Gerard F. Anderson, “Cross-National Comparisons Of Health Systems Using OECD Data, 1999,” Health Affairs, Vol. 21, No. 3, May/June United StatesGermanyCanadaSwedenUnited Kingdom

National Center for Policy Analysis Making Ideas Change the World Choosing between Health Care and Other Goods and Services Real Solutions

National Center for Policy Analysis Making Ideas Change the World From Hillary Care1.0 to Hillary Care2.0 Health Reforms That Don’t Work

National Center for Policy Analysis Making Ideas Change the World Problems Cost Cost Quality Quality

National Center for Policy Analysis Making Ideas Change the World Quality RAND study on Inadequate Care RAND study on Inadequate Care IOM Study on Medical Errors IOM Study on Medical Errors No Electronic Medical Records No Electronic Medical Records

National Center for Policy Analysis Making Ideas Change the World

National Center for Policy Analysis Making Ideas Change the World Why No Phone?

National Center for Policy Analysis Making Ideas Change the World Why No ?

National Center for Policy Analysis Making Ideas Change the World Why No Computers?

National Center for Policy Analysis Making Ideas Change the World Why Not Better Drug Advice?

National Center for Policy Analysis Making Ideas Change the World Why No Patient Education?

National Center for Policy Analysis Making Ideas Change the World What is the Source of Every Major Problem?

National Center for Policy Analysis Making Ideas Change the World The Way We Pay Doctors

National Center for Policy Analysis Making Ideas Change the World Payment for Physicians’ Services 90% Third-Party Payers 10% Out-of- Pocket

National Center for Policy Analysis Making Ideas Change the World No Price Competition No Quality Competition

National Center for Policy Analysis Making Ideas Change the World Exceptions to the Rule Cosmetic Surgery Cosmetic Surgery

National Center for Policy Analysis Making Ideas Change the World Exceptions to the Rule Cosmetic Surgery Cosmetic Surgery Lasik Surgery Lasik Surgery

National Center for Policy Analysis Making Ideas Change the World Exceptions to the Rule Cosmetic Surgery Cosmetic Surgery Lasik Surgery Lasik Surgery Walk-in Clinics Walk-in Clinics

National Center for Policy Analysis Making Ideas Change the World Exceptions to the Rule Cosmetic Surgery Cosmetic Surgery Lasik Surgery Lasik Surgery Walk-in Clinics Walk-in Clinics Telephone Consultation – for pay Telephone Consultation – for pay

National Center for Policy Analysis Making Ideas Change the World Exceptions to the Rule Cosmetic Surgery Cosmetic Surgery Lasik Surgery Lasik Surgery Walk-in Clinics Walk-in Clinics Telephone Consultation – for pay Telephone Consultation – for pay Consultations – for pay Consultations – for pay

National Center for Policy Analysis Making Ideas Change the World Exceptions to the Rule Cosmetic Surgery Cosmetic Surgery Lasik Surgery Lasik Surgery Walk-in Clinics Walk-in Clinics Telephone Consultation – for pay Telephone Consultation – for pay Consultations – for pay Consultations – for pay Concierge Doctors Concierge Doctors

National Center for Policy Analysis Making Ideas Change the World Exceptions to the Rule Cosmetic Surgery Cosmetic Surgery Lasik Surgery Lasik Surgery Walk-in Clinics Walk-in Clinics Telephone Consultation – for pay Telephone Consultation – for pay Consultations – for pay Consultations – for pay Concierge Doctors Concierge Doctors Medical Tourism Medical Tourism

National Center for Policy Analysis Making Ideas Change the World Illusory Solution Paying for Performance

National Center for Policy Analysis Making Ideas Change the World Paying for Performance Buyers Setting the Quality Standards Illusory Solution

National Center for Policy Analysis Making Ideas Change the World Providers Compete for Patients Based on Price and Quality Real Solution

National Center for Policy Analysis Making Ideas Change the World From Hillary Care1.0 to Hillary Care2.0 Health Reforms That Don’t Work

National Center for Policy Analysis Making Ideas Change the World Problems Cost Cost Quality Quality Access Access

National Center for Policy Analysis Making Ideas Change the World

National Center for Policy Analysis Making Ideas Change the World Expanding Government Insurance Programs Illusory Solution

National Center for Policy Analysis Making Ideas Change the World Crowd Out: Percent of New Coverage Offset by a Decline in Private Coverage Source: Jonathan Gruber. Medicaid Expansion (Low Estimate) Medicaid Expansion (High Estimate) S-CHIP

National Center for Policy Analysis Making Ideas Change the World Creating Access to the Private Marketplace Real Solution

National Center for Policy Analysis Making Ideas Change the World From Hillary Care1.0 to Hillary Care2.0 Health Reforms That Don’t Work

National Center for Policy Analysis Making Ideas Change the World

National Center for Policy Analysis Making Ideas Change the World

National Center for Policy Analysis Making Ideas Change the World

National Center for Policy Analysis Making Ideas Change the World

National Center for Policy Analysis Making Ideas Change the World Remembering the Message Queen of Hearts Seven Dwarfs Little Red Riding Hood

National Center for Policy Analysis Making Ideas Change the World National Center for Policy Analysis Making Ideas Change the World