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Health Reform, Past and Present
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Health Reform, Past and Present

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Dr. James Mongan spoke about "Health Reform, Past and Present" at the 10th annual William E. Petersen Symposium on Physician Leadership at the University of St. Thomas.

Dr. James Mongan spoke about "Health Reform, Past and Present" at the 10th annual William E. Petersen Symposium on Physician Leadership at the University of St. Thomas.

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  • 1. William E. Petersen Symposium University of St. Thomas Opus College of Business James J. Mongan, MD President & CEO Partners HealthCare October 7, 2009
  • 2. Outline of Remarks
    • Coverage Issues
    • Cost Issues
    • Future Challenges
    Petersen Lecture 10.7.09
  • 3. Health Financing Policy - Coverage
        • Facts on health care coverage
        • Why coverage is important
        • What we have tried to do
          • 1974 Nixon proposal
          • 1979 Carter proposal
          • 1992 Clinton proposal
        • The Massachusetts story
    Petersen Lecture 10.7.09
  • 4. Health Reform Outcome Predictions – July 15, 2009 Petersen Lecture 10.7.09
    • Bill passes, highly touted
    • Significant coverage improvements (50-60%)
    • Cost issues remain
    • Some concern over individual mandate backlash because of inadequate subsidies
    Outcome Element Yes No Compromise Individual Mandate 
    • Phased in plus many “ hardship ” exclusions
    Employer Mandate 
    • Small Massachusetts level penalties
    Public Plan 
    • “ Light ” public plans – no Medicare limits, state level, triggered in
    Payment Reform 
    • Payment cuts, not reforms – effective on Medicare only
    Adequate Financing 
    • Without employer mandates and with limited tax revenues, payment cuts not sufficient to fund adequate subsidies
  • 5. Health Financing Policy - Costs
        • Facts on health costs
        • Why costs are rising
        • Why we care about high costs
        • What we have tried to do
          • Regulate
          • Let markets work
    Petersen Lecture 10.7.09
  • 6. Health Financing Policy Future Policy Issues Focused on Cost
    • Steps to control baseline level of spending
      • Address variance
      • Address operating efficiency
      • Address administrative costs
    • Barriers to action
    Petersen Lecture 10.7.09
  • 7. Petersen Lecture 10.7.09
  • 8. Health Financing Policy Future Policy Issues Focused on Coverage
    • Major challenge – need for revenue
      • Cannot escape or evade
    • Likely any legislation will blend
      • Taxes
      • Employer payments
      • Individual payments
    • Key Issue – fairness of financing – who pays and how much
    Petersen Lecture 10.7.09
  • 9. Health Financing Policy Key Issue for the Future
        • Balance between individual liberty and justice for all
    Petersen Lecture 10.7.09

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