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It
would be easy, in this long run of important
presidential primaries, to be convinced that the
problems we have with our health care system can only be
resolved through government action and the political
process. After all, presidential candidates Hillary
Clinton, Barack Obama, and John McCain have each made
health care reform a central issue of their campaigns.
Political races are all about emphasizing stark
differences between positions. But I am encouraged by
how much today's political leaders recognize that our
health care crisis - despite that word "care" - is
fundamentally a business problem.
California Governor Arnold Schwarzenegger is one of
those politicians who understands the urgency for
reform. The health care company I lead, McKesson
Corporation, turned 175 years old this year. To help us
celebrate that proud milestone, Governor Schwarzenegger
spoke passionately and convincingly about the
opportunities we have before us to bring the health care
industry to another level of excellence.
I
believe he's right. Historically, every twenty years or
so, we have a debate in this country about health care
reform. So what's different now? We've enjoyed
incredible advances in medical practice and technology
over the last few decades. That's one reason why overall
costs have risen but it's also why American health care,
despite the criticism currently in vogue, is the envy of
the world. On the other hand, with the best of
intentions, the political solutions traditionally put
forward to make health care cheaper and more accessible
- like artificially capping costs, regulating the
services providers offer and restricting consumer choice
- have had the opposite effect. Nobody who runs a
business is surprised about that. What computer maker or
car dealer would worry about price, access or quality if
there was no competition for the customer and no reward
for distinctive service?
Business leaders across the country are keenly aware of
these issues. I am a member of the Coalition to Advance
Healthcare Reform, a group of more than 50 companies
advocating solutions to the health care crisis. In
regular conversations with top executives, I hear the
same concerns frequently. First, because health care
costs are soaring, our employer-based health insurance
system is hurting American businesses and the economy.
Every product or service an American company offers is
more expensive than it should be because employee health
care costs are added to the mix. In a global economy,
this is making it harder to compete with companies
abroad. Second, business leaders, with their background
in competitive markets and customer service, look at our
health care system and think, "What other industry could
operate like this and survive?"
In
most industries, top performing businesses excel by
being the low cost producer, putting out the best
product, and meeting or beating customer expectations.
The market works because consumers are able to choose
the services that meet their needs best. In the health
care industry, costs are distorted by government
interference in the market and quality differences are
disguised by a lack of consumer information and choice.
Moreover, while we can argue that "customer" is another
word for patient, would the customer in any other market
make critical decisions without concern for cost or
quality and put up with the inconveniences,
inefficiencies and high error rates of health care?
The
three remaining presidential candidates understand that
effective health care reform means preserving our
enviable ability to innovate while making the health
care industry more market-oriented and customer
friendly. The stump speech talking points about access
and cost containment don't always highlight this. But if
you view the details of their proposals, a different
picture emerges. Each candidate's agenda emphasizes
business fundamentals like quality, transparency, and
paying for outcomes. They also understand that the
current health care information technology boom is about
to revolutionize the way care is delivered, reducing
medical errors and administrative waste while making
efficiency, informed choice, lifelong care and
customer-orientation the new paradigm.
What's
more, all three candidates see the same critical areas
that need our most urgent attention. Chronic diseases
account for most of our health care expenditures and
require coordinated rather than episodic care. We need
to incentivize and organize providers to manage
long-term illnesses better. The fear of medical
malpractice suits are driving up costs by encouraging
unnecessary treatment. We need sensible reform to reduce
the preponderance of defensive medicine. Quality of care
and outcomes need to be the new measuring sticks by
which we assess, select and pay providers for their
health care services. We need greater transparency to
give primary care physicians and health care consumers
the ability to choose the best doctors, hospitals,
insurance providers and technicians, while also creating
industry-wide standards for the latest in best
practice.
No
matter which candidate prevails in November, the popular
concerns we have about health care right now are going
to evolve rapidly once the next administration begins.
As a business leader, I support universal access through
tax incentives and individual choice (not a de facto
expansion of Medicare) because I believe that having
everyone in the insurance pool is fundamental to
reducing costs and creating a competitive insurance
market. But as Governor Schwarzenegger learned when the
California Senate Health Care Panel rejected a bill
mandating health care for all state residents, sweeping
reform is even more difficult when economic times are
tough.
The
will for reform is real and the political process is
critical in building and maintaining the health care
industry we deserve. But as the candidates for president
realize, the kinds of forces that make American business
so competitive can make health care work better, too.
Higher quality, lower costs, greater transparency, and
better customer service are not contradictory goals,
they're outcomes that go together. We don't need to
control the health care market through mandates and cost
containment legislation, we need to unleash it by giving
people the ability to make better informed choices.
After all, health care is the one product all consumers
need, guaranteed.
Author:
John Hammergren
is CEO of McKesson Corporation, the Fortune 18
health care services leader. McKesson serves customers
at every point of health care and is helping transform
the industry into a modern, efficient, and
quality-driven system. McKesson has seen
industry-leading performance under Hammergren's
leadership. During his tenure, the company has more than
doubled its revenues and experienced a cultural and
business renewal. Hammergren is an HP board member and
the recipient of numerous awards for leadership. He is
the author of Skin
in the Game: How Putting Yourself First Today Will
Revolutionize Health Care Tomorrow. |