Health Reform: Where Do We Go From Here?

Cecilia Arradaza, Communications Director, FasterCures

With the health reform law in place, participants joining this year’s Milken Institute Global Conference had more questions than answers about its implications. A second panel on health reform convened Tuesday (Read Summary of Monday Health Reform Panel) looks at cost, coverage, and consequences.

“Cost comes from price [of health care] and utilization,” said Ceci Connolly who covers health policy for The Washington Post. Measures are in place to curb the soaring cost of health care services, like a measure that brings hospitalization costs down by lowering readmission rates by addressing preventable underlying causes. But, “we have a lot to do” when it comes to utilization. The law starts to modify behavior by changing incentives, but it requires broader public engagement.

Michael McCallister, President and CEO, Humana Inc. said that the power of consumers are great and can be leveraged with the right incentives, accurate information, and transparency throughout the health system.

The health reform law has measures in place that will move the country toward “outcomes-driven care,” said Billy Tauzin, President and CEO of the Pharmaceutical Research and Manufacturers of America.

The question now, according to Connolly is “who in the industry is going to innovate?” She noted that “we will see creative, money-making ways” as implementation of different aspects of the law is actualized.

Tauzin said that the law contains protections for biopharmaceutical research if implemented right. To which Connolly pointed out that these protections, the issue of 12-year exclusivity for biosimilars is an ongoing argument among policymakers.

Among the law’s missing links, according to Connolly, was a delay in convening a new Medicare Commission (scheduled for 2014) to examine and improve the Medicaid dental coverage for adults, and no “death panels,” which were never “death panels” to begin with.

Tauzin said the law does not address the litigation system to stop ‘defensive medicine.” The fear of liability encourage healthcare providers to overutilize unnecessary health care service which lead to rising costs that do not necessarily bring better care.

Sandy Beaty, Senior Vice President, Public Affairs, Pfizer Inc., said that implementing this complex health reform law is a five to ten year process.

When panel moderator Sage Kelly of Jefferies & Company asked if timing was right, Tauzin said had the Congress and the President not acted, it would’ve take another 10 years to revisit the issue.