By James Call, The Florida Current
Tom Feeney, CEO of Associated Industries of Florida, welcomed more than 300 people to a statewide health care conference in Orlando by warning them they will be offended by what they hear during two days of presentations and discussions.
“We have invited not only some of the smartest and practical policy experts in the country to lay out different ideas and options for policy makers,” Feeney said. “If you pay attention you are going to be offended by something said by somebody at some point. If you are not offended then you didn’t pay attention.”
Keynote speaker Michael Millenson, president of Health Quality Advisors and a former CEO of the Clinton Foundation, said that now is a revolutionary period for health care. Millenson defined a revolution as a transfer of power, saying that in order to control the cost of health care, the United States needs to change into a system that holds providers, health plans and patients accountable.
“We are changing the balance of autonomy and accountability. And that is tough. That is revolutionary. That is difficult because nobody likes losing power. Nobody likes losing autonomy,” Millenson said.
“We’re taking power away from the providers to do anything they want and saying, ‘no, you are going to be held accountable.’ We’re taking power away from health plans, (they say) ‘don’t worry I know what I’m doing,’ (but employers) are holding them accountable. Frankly, although we don’t say this out loud, we are taking power away, in some ways, from the individual patient. No, your insurance card does not entitle you to get anything you want,” Millenson said.
Millenson, a former journalist with three Pulitzer Prize nominations, is a visiting scholar at Northwestern University. He wrote a book – “Demanding Medical Excellence: Doctors and Accountability in the Information Age” – about the use of technology such as computers and algorithms to highlight best practices and flag treatments and procedures that are not cost effective.
For Millenson, the problem is the current focus on health care outcomes that he said can’t be measured accurately. The focus, he contended should be on processes that can be measured. He cited an Institute of Medicine Roundtable study that estimates a third of all health care spending – $765 billion nationally – is waste, consumed by fraud, and unnecessary testing and procedures. He said that hurts U.S. competitiveness in the world economy and costs jobs when employers move elsewhere to avoid the expense.
His prescription is to control costs by using technology to measure processes and results, to change expectations about health care and to develop a system that focuses on wellness instead of sickness. That is keeping people healthy rather than waiting for them to get sick.
He noted that almost a third of Florida’s state budget is spent on Medicaid.
“Rather than investing in our kids we paying for sickness,” said Millenson, who this year wrote a commentary GOP to Uninsured: (Feel Free to) Drop Dead. “This weakens us a society. This weakens us for the future.”
The health care conference, organized by AIF, brought more than 30 experts, academics and lawmakers for a free-flowing discussion on health care. Feeney said it is part of the groups’ fact finding to develop proposals for the Florida Legislature in 2013, 2014 and 2015 and beyond. In his opening remarks for the conference he said AIF will be agnostic about health care solutions until the conference ends and then it will become a very forceful and powerful group of lobbyists.
Speaking after Millenson’s presentation, Feeney indicates he sees a different type of revolution than the one Millenson mentioned.
“I think he basically told employers what they already know, which is employers don’t have to provide healthcare for a majority of Floridians. They can move elsewhere,” Feeney said. “I think what Mr. Millenson said was Florida is simply not going to have a prosperous economy, not going to have job creation, if we don’t get healthcare right.”