William E. Petersen Symposium University of St. Thomas Opus College of Business James J. Mongan, MD President & CEO Partne...
Outline of Remarks   <ul><li>Coverage Issues </li></ul><ul><li>Cost Issues </li></ul><ul><li>Future Challenges </li></ul>P...
Health Financing Policy - Coverage <ul><ul><ul><li>Facts on health care coverage </li></ul></ul></ul><ul><ul><ul><li>Why c...
Health Reform Outcome Predictions – July 15, 2009 Petersen Lecture 10.7.09 <ul><li>Bill passes, highly touted </li></ul><u...
Health Financing Policy - Costs <ul><ul><ul><li>Facts on health costs </li></ul></ul></ul><ul><ul><ul><li>Why costs are ri...
Health Financing Policy Future Policy Issues Focused on Cost <ul><li>Steps to control baseline level of spending </li></ul...
Petersen Lecture 10.7.09
Health Financing Policy Future Policy Issues Focused on Coverage <ul><li>Major challenge – need for revenue </li></ul><ul>...
Health Financing Policy Key Issue for the Future <ul><ul><ul><li>Balance between individual liberty and justice for all </...
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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.

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Health Reform, Past and Present

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

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