1. The Future of Health [sick] Care or The Thoughts of a Grumpy Old Man

2. THE FUTURE OF HEALTH CARE

3. Arthur Hoppe; “The Waiting Game”, 1980; Russell Bakers Book of Humor in America: (with apologies)

5. The Iron Triangle QUALITY ACCESS COST

6. Three Major Issues Complexity Role of government $$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$

7. The future of health care? Issue One “The future will not be resolved until we fully grasp the complexity of the political, economic, technological, and sociological forces in the United States that are a part of health care.” Grumpy old man

8. It’s all connected We eat 300 more calories a day than we did 25 years ago We all weigh on average ten pounds more We have a serious epidemic of: - Obesity - type 2 diabetes - heart disease - diet related cancers

9. It’s all connected Chronic disease adds $250 Billion dollars/per year to health care cost The generation being born now will have a shorter life span than their parents One in three Americans born in 2000 will have type two diabetes. Each individual winds up spending an additional $14 K/year for health care

10. It’s all connected Federal Government spends $25 Billion a year in farm subsidies. We subsidize corn, wheat, soy, rice and cotton Can you say fast food while you are drinking your diet soda today! Results in a war between public health goals and agriculture policies. (From a Bill Moyers interview with Michael Polan on Bill Moyers Journal)

11. The future of health care Issue two “The future will not be resolved until the United States comes to a consensus on the role of government in our society.” Grumpy old man

12. Political Forces: Role of Government Left Government is the best option for the delivery of health care services. Right Little or no government involvement. Private sector is the best means to delivery of health care services.

13. Sociological Forces Politics is the “art of compromise” Today the political arguments have become theological Theology does not allow compromise

14. The Future of Health Care Issue Three How do we deal with all the money in system? “ we were all making too much money” Hank Paulson in HBO’s Too Big to Fail

15. The Future of Health Care What do we mean by “health care”? Is health care a business/industry? Are we patients or are we consumers? Does competition reduce costs? How many MRIs are enough?

16. Health Care Regulation? Do more with less! Role of State versus Federal? Role of Private versus Government?

17. QUESTIONS????? For the Conference Is there an inherent conflict of interest in entrusting much of the oversight of health care professionals to organizations that the professionals themselves control? What are the arguments for and against relying on private regulators as a part of the oversight process?

18. QUESTIONS??? DOES AMERICA NEED A SYSTEM OF UNIVERSAL HEALTH CARE COVERAGE? PRIVATE OR GOVERNMENT? HOW WOULD WE REGULATE IT?

19. QUESTIONS??? OVERALL, TO WHAT EXTENT DOES REGULATION IMPROVE HEALTH CARE IN AMERICA? OVERALL, TO WHAT EXTENT DOES REGULATION CREATE INEFFICENCY AND INCREASE THE COST OF HEALTH CARE IN AMERICA?

20. “ I am an old man and have known many tragedies, but most of them never happened.” Mark Twain

21. Thank You!