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CEOs’ Urgent, Shared Commitment to Change

2008_GaryKaplan

A few weeks ago, I joined five of my peers in health care leadership throughout the country to help launch Health CEOs for Health Reform, a coalition dedicated to transforming health care and creating a more sustainable health system. 

In mission, we committed to moving past policy concepts toward a detailed blueprint that would reconcile legislative goals with operational realities of the health care system. Our goals are lofty and the challenges immense. What struck me in recent months, with the current state of the economy, is the tremendous sense of urgency we all feel and the confidence we have that now is the time to truly transform health care. 
 

I read Michael Millenson’s post The Inevitability of Health Care Reform: This Time, the Politics Have Changed with great interest and personal reflection. What is different this time around? What do I think a handful of health CEOs can really do to change a system entrenched with waste and cost that does not add value to our very customer – the patient? 

First, it was clear to me last week that it is no longer “business as usual” for any of us. Health care reform can no longer be set aside or merely discussed. The New America Foundation has given us an opportunity to help make a difference and contribute to reforming our health system, but it is up to all of us to make the hard choices that will work – and every one of us will have to give up something for the better good.

As a medical doctor and a hospital administrator, I am proud to be a part of American medicine, but we can be much, much better. No other industry in the world tolerates the quality problems health care accepts as status quo. 

The defect rate in health care approaches 3 percent. Consider the gap in quality if other industries accepted a similar defect rate — about 2,000 airplanes would have unsafe landings a day, 12,000 checks would be withdrawn from the wrong account each day, and 20,000 pieces of mail would be erroneously delivered every hour. These levels of poor quality would be totally unacceptable.

As if quality standards were not enough to make the case, we’re also not getting what we pay for. According to a recent Washington Post article, U.S. health care represents about 16 percent of the gross domestic product (more per capita than any other nation in the world), yet we lag considerably in overall health. We’re 29th in infant mortality, 48th in life expectancy, and the worst of 19 industrialized nations in preventable deaths.

Our health care system is fraught with waste, which leads to poor quality and excessive cost. Nearly half of the $2.6 trillion in the U.S. health care system is waste that adds no value for patients and sometimes even causes harm. 

At Virginia Mason Medical Center in Seattle, we’re using our Virginia Mason Production System management method (modeled after the Toyota Production System) to show how health care can reduce cost while improving quality and safety. By eliminating the waste, we have seen over and over again improvement in quality, safety and the patient experience – all while reducing cost.

We’re seeing results in every area of our health system: ambulatory care, inpatient care, facility design, chronic disease management, finance, supply and the list goes on. As a result, we’ve created an environment where dedicated care teams can actually do their best work and have more value-added time with patients.

I’m confident patients in our country can get higher quality and safer care at less cost. It first requires participation of employers, health plans, government and others to truly achieve what is possible. 

At Virginia Mason, our work with employers, like Starbucks, Costco, Boeing and Microsoft, is yielding dramatic reductions in costs for those paying the bills; and better care, quicker return to work and more satisfaction for our patients. We, unfortunately, in the current payment system, reduce our profitability by doing the right thing. Despite my very supportive board of directors, they will not allow me to lead our organization into bankruptcy by doing the right thing. We need to change our payment system if we truly want to ensure universal coverage, improve quality and reduce cost. 

We all need to change our mindset and commit to our shared agenda of cost, quality and coverage. It will require delivery system reform and payment system reform. We must stop giving incentives to hospitals and physicians to do the wrong thing to provide non-evidence-based, non-value-added diagnostic and therapeutic interventions. 

We have seen what’s possible and we are anxious to share our experience improving care and reducing cost. It isn’t easy, but we are ready to roll up our sleeves and make it happen. The prize is worth it: quality, affordable health care for all Americans.

Gary Kaplan, MD is Chairman and CEO of Virginia Mason Health System in Seattle.

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Matthack facebook absolutely freeeddieGary M RuehleGary Lampman Recent comment authors
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Matt
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Matt

IT IS SAD THAT SCUMBAG IMMIGRANTS LIKE DESAI AND THEIR CROOKED ILK FROM GUJARAT, INDIA IS TAKING OVER OUR HOTEL INDUSTRIES AND NOW INSURANCE INDUSTRIES AND BANKRUPTING OUR PEOPLE…. THEY HAVE IMPORTED HIGH LEVEL CORRUPT PRACTICES FROM INDIA AND ARE USING IT HERE.

IN INDIA IT TAKES MILLIONS TO BUY A PARLIAMENTARIAN BUT IN THE US IT TAKES ONLY A FEW THOUSAND DOLLARS DONATION TO PUT HIM IN THEIR POCKET. SUCH IS THE STATE OF OUR COUNTRY.

WE HAVE BECOME A SPINELESS PEOPLE WHO TRY TO BE POLITICALLY CORRECT AND IN RETURN GET SPIT ON OUR FACE.

hack facebook absolutely free
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It all the time amuses (and frustrates) me that one of the crucial important, disruptive
tools of our time is handled with disdain.

eddie
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eddie

Universal health care inc, st petersburg, fl is a company that had to pay 300-400 million aqs a fine for medicare/medicaid fraud. And if the tried to screw medicare imagine what they can do to you. Also this medicare advantage plan co is owned by de desai from india & believe all your personal & medical records are sent to india for procesing, ss#,ph#, address, and medical records. I know as I use to work there & i use to scan all claims including high dollar claims & have it scanned to NDS in india, only to have them denied… Read more »

Gary M Ruehle
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It is SO simple to get ALL Americans very inexpensive FULL coverage for ANY medical need with no pre-existing condition exclusions. Get rid of the for profit insurance companies that pay their criminal CEO’s hundreds of MILLIONS of dollars in obscene salaries and bonuses. They get this money through post claims underwriting and denial of justifiable services killing over 50,000 adults and 25,000 children EVERY YEAR in their need for greed. This is murder for profit and no one is doing anything. This is why a single payer plan would work, it would eliminate BILLIONS of dollars in CEO salaries… Read more »

Gary M Ruehle
Guest

DOMESTIC TERRORISM We have all read and heard horror stories about medical insurance companies and how they just plain refuse to pay for covered medical services and the horrible and life threatening and crippling strain this puts on the average American citizen, his family and his friends. Here is my personal horror story dealing with Universal Health Care Inc of St. Petersburg Florida, their CEO Dr. Akshay Desai from India and his medical director Dr. Edward Lowenstein. ENOUGH IS ENOUGH! My story is repeated tens of thousands of times every year putting Americans into medical bankruptcy and worse, death! This… Read more »

Gary Lampman
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Gary Lampman

In reference to Rush Limbaugh’s comments that He is proof that we have the Best Health Care (that Money can BUY) in the world.

Gary Lampman
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Gary Lampman

Oh, No special treament for the fat Blowhard who has put a Free advertising plug in for the Industry. Tort Reform is not the issue as only 1 to 5 %percent of lawsuites proceed with any rewards. These are the most serious Cases of Medical Error that end in a lifetime of infirmity, Disability and Death. Tort Cases are the ONLY means of accountability! Otherwise, the patient would bare the insurmountable costs of Medical Error. The problem is,neither the doctors or the institutions want to be Held accountable for anything that may happens. If it be Medical Error or Hospital… Read more »

Sonia
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I’m passionately involved in helping people get quality healthcare at a low discounted price. Please go to http://www.mybenefitsplus.com\40660056 If you are interested in becoming a rep. please go to http://www.weenjoyfreedomfromhome.com

K Walsh
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K Walsh

Medicine must return to it’s role as a profession, not a business. The health insurance companies continue to compensate their executives out of proportion to any known formula. This executive compensation—millions of dollars every year—could be used to provide healthcare for millions of Americans. ANNUAL COMPENSATION OF HEALTH INSURANCE COMPANY EXECUTIVES (2006 and 2007 figures): • Ronald A. Williams, Chair/ CEO, Aetna Inc., $23,045,834 • H. Edward Hanway, Chair/ CEO, Cigna Corp, $30.16 million • David B. Snow, Jr, Chair/ CEO, Medco Health, $21.76 million • Michael B. MCallister, CEO, Humana Inc, $20.06 million • Stephen J. Hemsley, CEO, UnitedHealth… Read more »

Hal Andrews
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While there are clearly examples of “doing the right thing” having a detrimental effect on reimbursement, there is still ample opportunity to improve the variance in quality on a day-to-day basis INSIDE each hospital. Virginia Mason does a better job than most, but a cursory review of public data on hospitals reveals that the way in which care is delivered is unacceptably and unexplainably different from day-to-day. When hospitals can produce the same “output” every day of the week, then the focus on perverse financial incentives will be more powerful.

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Good information.

Deron S.
Guest

That’s exactly my point. We shouldn’t have to force people to take care of themselves. Let me break this down a different way. Our current system is wasteful and we all know that. I just don’t understand why you want to focus on the symptoms of that waste. Let’s attack the underlying problems that caused those symptoms. If we get people healthier and do it at the primary care level, there will be less healthcare transactions. What will that mean? Less demand for specialist services, less financial incentive to continue the spread of costly imaging modalities, less need for administrative… Read more »

Peter
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Peter

“The main reason is because the beneficiaries are not compliant with treatment plans and not willing to make all of the necessary changes to their lifestyles.”
How do you force them?

Deron S.
Guest

You can prevent pre-diabetics from become diabetic in a very short period of time. You can get people to stop smoking and realize benefits quickly. What you’re suggesting is that we are a stubborn nation that can’t change, so we need a workaround instead. Chronic conditions make up 75% of our healthcare spending Peter. Most chronic conditions are preventable. There is no faster way to drive down costs than to treat current and prevent future chronic conditions. Budgets don’t change that. Your wonderful public program called Medicare is having a horrible time with it’s Demonstration projects. The main reason is… Read more »

Peter
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Peter

Deron, the true and transparent cost will be seen if there is a dedicated tax for healthcare, both at the federal and state levels. I’m not advocating using the taxpayer as a blank check, like Wall Street/Detroit is, I’m advocating a public system to reduce costs and save us money. But we will need budgets with a public system or it will fail as is the MA plan. If you think our unhealthy habit culture is what is driving costs then you will chain yourself to the approaching 20+GDP for healthcare. Not sure if that scares you or not. Even… Read more »