Michael Millenson, moderator—Intro—consumerism is a legacy of the Clinton health plan and the backlash against managed care

Bill McGuire, UnitedHealth Group— Health care system doesn’t work well—doesn’t work in any country, so it doesn’t matter who pays for it. It is time to drive for change, and consumerism can advance it on behalf of everyone.

We’ve got a problems and every constituent has got a problem—wont get better with fundamental change. United thinks that trend is slowing but Wall Street thinks that’s a problem as they wont be able to charge so much. Left to the system that we have, all use will be inappropriate. We need to re-use re-design what we have to make use of new tech, need to help individual anticipate those needs. Need to build (what looks like a damn complex system in his slide) an inter-operable system around the consumer.

He believes that personal coaching will help consumers. And that this series of problems can be solved across the continuum. Where benefits change matter— the important thing is what tools are there to make this consumer care work? The results so far: Discretionary use in outpatient services is down, apparently no evidence of diminished use of necessary services (although that’s not what the RAND experiment said). But we need to add the support to the system, and also get consumer credit into the health system.

Meanwhile I am also at the same time running the questions from the audience which are delivered over wireless devices and laptops by a clever little company called VisionTree. You can guess what they’re about today! But the moderator is keeping the subject on the one at hand, despite the frenzied concern of the United PR flack who appeared over my shoulder.

Overall I have a limited understanding what he means by his explanation of the universal consumer-focused system. His slide is called “A modern vision for the integration of Comprehensive Assets focused on the individual” —  I think he needs a new copywriter. But the key idea is the main hope that consumer directed care will work. 

On the other hand, despite the criticism of United and McGuire in today’s news, at least compared to may corporate CEOs of late who also have huge paydays he at least has led a company that has consistently increased earnings. And frankly it’s not exactly his fault (or that of other insurers) if their customers have let them get away with lowering their medical loss ratios year after year.

John Brennan,Vanguard Chairman & CEO,—  believes that the consumer is smart. The defined contribution market  has grown and they’ve grown with it. There are 4 main needs to serve consumers. 1) Effective candid communication and education…keep it simple. 2) Technology (especially real time information) 3) Providing choices 4) Willingness to adapt and evolve.

Jim Guest, Consumers Union—test products, get it out to consumers in plain English.  They’re pushing for that in health care. what have they learned? Give the public a consistent format so that they can compare one to another to another. Like a nutrition content guide on the back of food products, and the same template on credit cards. they are starting to do that with drugs, at bestbuydrugs.org Insurance institute for highway safety crash test cars and gives that information out—in the mid 1990’s half the side crashed vehicles ended up in marginal category, now it’s barely any 10 years later. Finally lets get Medicare data about physicians out. Business Roundtable, consumer groups and others all want to get that information out.

Michael asks….

Should you move to consumer directed health plan?

John Brennan—We offer consumer plans, but not very popular.Need to do a better job explaining it. Only 10% at Vanguard have chosen it so far. He talked to a lawyer/accountant this morning who couldn’t understand what the option meant.

Jim Guest—Consumer’s union supports consumer informed health care—consumer driven healthcare seems to mean a different thing. The consumer voice hasn’t been strongly heard. more driven by industry than by consumers. They don’t offer a consumer driven option

Why do I need a HDHP to take part in this wonderful consumer information?

McGuire—you don’t need one. We need a system that people can access. But some of these elements have no applicability for some portions of the population. and it’s a disservice to put the wrong people into that situation. But the consumer support is necessary for everyone.

McGuire—Price alone is not a good guide, Need the cost over a population over time….

Are we going to have another panel in 5 years with another buzzword like we did with managed care/capitation?

McGuire—managed care advocates weren’t very insightful! I would never had said that! this time there are fundamental issues that will be long lasting —information is fundamental, technology will be fundamental, so its a different situation.

Guest—whatever direction this goes, consumers will have to be put in the legislation/business forefront. that genii is not going back in the bottle.