


In 2007, CED released a policy statement with recommendations to improve the quality, cost, and coverage of health care. CED concluded that public policy change at the federal level is necessary to improve both the quality and the affordability of health insurance. Reforms are urgently needed to align the incentives of health-care providers and consumers to stop the current unsustainable growth in costs and decreasing insurance coverage for Americans. Employers acting alone cannot achieve the necessary changes. A public-private solution, which CED calls "market-based universal health insurance," is needed to meet the demands of a modern economy for a healthy, mobile workforce.
CED, in partnership with The Peter G. Peterson Foundation, is sponsoring a series of CEO and policy expert roundtables on the long-term fiscal and financial health of the country. The first policy forum will focus on health care reform.
Health care is by far the largest contributor to projections of the nation's growing public debt burden.
The cost of insurance is rising faster than wages, or total income in the economy, which is not sustainable. The United States spends up to twice as much on health care, per capita, as other nations with equal or superior life expectancies and other health outcomes.
As key stakeholders in the fiscal well-being of the American economy and the main suppliers of health insurance to the working-age population, business leaders are uniquely positioned to play an influential and constructive role in helping policymakers to get the country back on track. The health care crisis, and the challenge of a rising public debt, will not be solved without enlightened leadership from the business community.
To learn more about CED's work on health care reform please contact Amy Morse at amy.morse@ced.org or 202-296-5860 ext 32.
CED is a founding member of the Better Health Care Together Coalition (BHCT). In partnership with the Service Employees International Union (SEIU), Wal-Mart, AT&T, the Howard H. Baker, Jr. Center for Public Policy, the Center for American Progress, the Communications Workers of America (CWA), Intel, and Kelly Services, the group released a set of four common sense principles for achieving a new American health care system by 2012.
The announcement event featured the remarks of CED President Charles Kolb (view video), as well as remarks from business leaders, organized labor, and public policy groups.
February 7, 2007 Washington, D.C.
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May 9, 2007 New York, NY
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January 11, 2008 Little Rock, AK
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March 10, 2008 Portland, OR
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April 25, 2008 Milwaukee, WI
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Milwaukee, Wisconsin — On Friday April 25, 2008 CED, in partnership with Better Health Care Together coalition members Manpower, the Service Employees International Union (SEIU), and League of United Latin American Citizens (LULAC) sponsored a forum with more than 90 regional business, labor and philanthropic leaders to discuss health care reform.
At the event, the Better Health Care Together Coalition released a paper entitled, “Health-Cost Crossroad: Why American Businesses Urgently Need to Fix the Health System,” evaluating the impact of increasing health care costs on employers and the workforce. The Better Health Care Together Coalition identified the following problematic trends:
Health care costs are increasing more rapidly than economic growth: Employer-based health insurance premiums have risen by 98 % between 2000 and 2007, nearly five times faster than the rate of inflation.
Fewer employers offer health insurance: The proportion of firms offering health benefits fell from 69 to 60 percent between 2000 and 2007. About 80 percent of the uninsured are in working families.
New challenges in a changing economy: Jobs have shifted to service industries, whose share of employment climbed from 31 percent in 1900 to 78 percent in 1999. Non- traditional workers now comprise 20 to 30 percent of the U.S. workforce. They are temporary employees, independent contractors, free lancers, independent professionals, and consultants. Compared to traditional employees, they are at a significant disadvantage with respect to health insurance both in terms of price and public policy, which favors employer coverage.
Impact on small businesses: Health benefit costs tend to be higher for businesses that have fewer workers to bear the administrative costs and risk. Because of this, only 45 percent of businesses with fewer than 10 workers provided health insurance in 2007 — down from 57 percent in 2000.
The unsustainable, disturbing trends in increasing cost, decreasing coverage and problematic quality of health care has led coalition members to press political leaders to act by 2012. The Better Health Care Together Coalition has convened forums in Little Rock, Arkansas hosted by Wal-Mart; Portland, Oregon hosted by Intel; and Milwaukee, WI hosted by Manpower.
Mary Kay Henry, Executive Vice President, SEIU and Congressman Paul Ryan (R-WI) delivered welcoming and keynote remarks at the Milwaukee forum. Congressman Ryan applauded the Better Health Care Together Coalition for bringing such a diverse group of leaders together, noting, "Instead of being at each other's throats on this issue in Washington or Madison, we ought to figure out what we believe in that's in common and work off of that." Congressman Ryan noted the need for health care reform legislation in Washington is urgent. Milwaukee residents struggle with extremely wide variations in cost for the comparable health services. Congressman Ryan noted the need for a national plan that would eliminate systemic disincentives that keep costs high and bar access to care for thousands of Wisconsin residents.
Lieutenant Governor Barbara Lawton moderated a discussion on "The Need for Health Care Reform: Business-Labor Perspectives." Speakers included Jeff Joerres, CEO, Manpower; Darryl Morin, CEO, Advanced Wireless; Scott VanderSanden, President, AT&T Wisconsin; and Tom Verkuilen, CWA Representative.
Manpower CEO and CED Trustee Jeff Joerres discussed the impact of health care on US global competitiveness and the need to forge unique partners and raise awareness among stakeholders. Joerres noted that the failure of policy makers to address this has left the US misallocating investment dollars from workforce training and development, to benefits packages which have little to no transparency in effectiveness. From his perspective as an international business leader, the inability to use investment dollars more effectively has rendered US businesses less competitive. Joerres added, "Business, unions and government have to consider an open dialogue."
Lieutenant Governor Lawton moderated a second panel discussion on "The Need for Health Care Reform: Policy Perspectives." Lenny Mendonca, Director, Co-Founder of Public Sector Practice & Chairman, McKinsey Global Institute, McKinsey & Co.; Charlie Kolb, President, Committee for Economic Development; and Paul Nannis, Health Policy Consultant.
Charles Kolb discussed findings from the CED report, "Quality, Affordable Health Care for All: Moving Beyond the Employer-Based Health-Insurance System." Kolb discussed the unsustainable growth in the cost of health insurance and the decline of employer-based health insurance. CED proposed replacing the present employer-based health insurance system with transparent regional markets in which private insurance plans must compete for individual health care consumers. The plan addresses the major challenges in the existing healthcare system: cost control, access to care, quality of care and flexibility in the new American economy. CED's proposal offers systemic incentive structures that link health consumers to a transparent, market-based menu of insurance plans. Regional exchanges would be overseen by a "Health Fed" modeled after the Federal Reserve, a politically disinterested body that would act as a market stabilizer. The CED proposal is very similar to the Wyden Bennett Healthy Americans Act (S:334), which according to budget estimates, will save $1.48 trillion over 10 years; and be fully paid for with the $2.2 trillion currently spent on health care in America today. A recent Congressional Budget Office (CBO) and Joint Committee on Taxation report announced that the plan would be budget-neutral by 2014.
CED Trustee Lenny Mendonca, Director, Co-Founder of Public Sector Practice & Chairman, McKinsey Global Institute (MGI) cited research from the January 2007 MGI report investigating the high cost of American health care, Accounting for the Cost of Health Care in the United States. The report revealed that the US spends nearly $500 billion more than other wealthy nations without achieving significantly greater gains in outcomes, spending 16 percent of Gross Domestic Product (GDP) verses the Organization for Economic Co-operation and Development (OECD) median of 8.5 percent. Mendonca concluded, "Piecemeal reforms are not likely to make a difference. Only comprehensive reforms that address both supply and demand and skewed incentives and economic distortions that exist throughout the system are capable of fixing a system that is fundamentally flawed."
The event was covered by a regional C-SPAN affiliate, Wisconsin Eye and may be viewed or heard here.
Friday, February 8, 2008 - CED, in partnership with the Bay Area Council, hosted a release event and forum on the Digital Connections Council's latest report, Harnessing Openness to Transform American Health Care. The report explored how American health care can be greatly improved by embracing openness throughout the health care industry.
More than 80 senior business, education and civic leaders convened for the event, featuring keynote speakers Peter Jerram, CEO of the Public Library of Sciences and Elliot Maxwell, Digital Connections Council Project Director and Communications Program Fellow at Johns Hopkins University. Panelists included Lloyd Dean, CEO, Catholic Healthcare West; Jamie Ferguson, Executive Director of Health Information Technology; Strategy & Policy, Kaiser Permanente; Donald Holmquest, CEO, California Regional Health Information Organization (CalRHIO); and Benjamin R. Williams, Senior Vice President & Chief Information Officer, Catholic Healthcare West.
Several of the speakers lamented the lack of national leadership on standardization and broad consensus building on proprietary regulations that slow the speed of helpful forms of openness. Panelists concurred greater openness would lead to improved outcomes in cost, speed and quality of treatment as well as enriching health data available to doctors and scientists. However, basic computing advances that have allowed other industries to add incredible efficiency to their organizational structures have not made comparable gains in the field of health care delivery systems. Speakers suggested a number of possible reforms, namely, the development of a broad national coalition to work with government to establish guidelines for increased openness and standards to dictate forms of interoperability.
Several studies noted in the CED report have found that it takes 13-17 years for 14 percent of research findings to get into general medical practice. Harnessing Openness to Transform American Healthcare recommends greater openness through making information available under far less restrictive conditions and increasing the ability of others to contribute to it, so that, for example, research findings are more actively disseminated, become part of medical best practices, and improve patient outcomes.
For this report, the DCC decided to look at how openness was being or might usefully be employed throughout the healthcare arena. This area, which now constitutes approximately 16-17 percent of GDP, has long frustrated policymakers, practitioners, and patients. Bringing greater openness in different parts of the health care production chain can lead to substantial benefits by facilitating collaboration, speeding research, stimulating innovation, lowering costs, reducing errors, and closing the gap between discovery and treatment delivery.
The report focuses in part on biomedical research and the disclosure of research findings, the processes for evaluating drugs and devices, the emergence of electronic health records, the development and implementation of treatment regimes by caregivers and patients, and the interdependence of the global public health system. Areas covered include (topic in bold):
Biomedical Research is being transformed by the success of the Human Genome Project (HGP). The HGP demonstrated the possibilities of mass collaboration and the beneficial results of allowing data to be accessed immediately and manipulated by researchers around the world. Other research projects have adopted this open model and are flourishing by encouraging collaboration, and sharing data, applications, and even network resources. The DCC recommends that the federal research agencies push further by enunciating clear policies favoring openness, funding further work on standards for protocols, formats, terminology and nomenclature that allow the sharing and manipulation of data, and supporting experiments with differing levels of openness to determine the optimal level of openness for research under various scenarios.
In Clinical Trials, questions about the openness of clinical trials have been raised vigorously over the last decade. Although the Food and Drug Administration (FDA) had long required the registration of clinical trials involving life-threatening interventions, there have been disputes as to the completeness of these registrations and about the lack of registration of other clinical trials. Advocates of greater openness here and around the world have been concerned not only about registrations, but also about access to trial results and, perhaps more important, to the data that underlie the results and whether the data will be available in a computable form. The report calls for greater availability of data from trials in electronic form to speed research and detect possible safety problems.
The use of Electronic Health Records (EHRs) raises new openness issues. Utilizing such records, caregivers at any location would have access to a patient's medical history. Results of tests and treatments could be added easily as they become available, thereby improving treatment, preventing duplicative testing, and reducing medical errors. Eventually, EHRs could be constructed including family medical histories, genomic and pharmacogenomic data, environmental exposures, lifestyle and other information, easing the way toward the personalization of treatment. The aggregation of such records and others could then facilitate the achievement of a genuine evidence-based medical system. Such records provide far richer data than clinical trials, and could serve as the basis for predictive models similar to those used in other scientific domains. Harnessing Openness to Transform American Health Care stresses these benefits but recognizes the need to protect patient privacy and data security if the potential gains from EHR's are to be realized.
The DCC believes that greater openness in software-controlled Medical Devices creates new opportunities and challenges. The history of practitioner innovation in scientific instruments and the malleability of software suggest the potential for a dramatic increase in practitioner-driven customization. The report recommends that the FDA begin an examination of how to benefit from the user-driven innovation while maintaining appropriate oversight for safety and efficacy.
The United States has long been a leader in medical innovation and treatment. Health care continues to grow as a percentage of our economy. Future economic growth will benefit by greater openness in the field. The recommendations in Harnessing Openness to Transform American Health Care provide a way to greater access to information by more people, and more possibilities for them to contribute based on their own expertise and energy. "It shows us a path to improve health care without great additional expense," said Charles Kolb, CED President.
The U.S. employer-based health care system is failing. With health care costs rising faster than wages, quality of care low, and access to coverage deteriorating, fundamental restructuring of the current health care system is necessary. The new CED report was the center of discussion at a Washington, D.C. luncheon on November 7, 2007 [agenda]. U.S. Senators Ron Wyden (D-OR) [audio] and Robert Bennett (R-UT) [audio] joined Congressman Jim Cooper (D-TN) [audio] and a group of business and policy leaders in at a forum focused on health care reform. The new CED report was released at a business luncheon forum in San Francisco on October 15, 2007, and examines the causes of that failure, and recommends a universal, market-based health-insurance system. Senator Wyden, Senator Bennett, and Congressman Cooper each stressed that the U.S. health care system needs reform and now is the time for action. All three have introduced health care reform legislation in the Congress.
Findings of the CED report were first presented at a forum in San Francisco on October 15, 2007 [agenda] by CED Trustee, co-chair of the CED Health-Care Subcommittee, and Chairman of Nektar Therapeutics, Robert Chess [audio]; and Dr. Alain C. Enthoven [audio], Marriner S. Eccles Professor of Public and Private Management, Emeritus, and Faculty Member at the Stanford University Center for Health Policy. "There are successful models for consumer choice of insurance plans, including the federal employees plan," said Mr. Chess. "The CED proposal builds on the best of those ideas and adds some new ones to achieve affordable, sustainable, quality coverage for all Americans." Dr. Enthoven and CED Trustee William Lewis [audio] presented the findings and recommendations of the CED report at the Washington, D.C. forum, held at the Hyatt Regency Capitol Hill Hotel.
In San Francisco, George C. Halvorson Kaiser Foundation Health Plans CEO and author of Health Care Reform Now! delivered keynote remarks [audio]. The panel, moderated by Pacific Business Group on Health CEO Peter V. Lee included, Dr. Anmol S. Mahal, President, California Medical Association; Sally Covington, Executive Director, California Health Care Coalition; Jeffrey Mains, Assistant Vice President, Health Plans, AT&T; and Dr. Harold S. Luft, Professor of Health Policy and Health Economics at the Institute for Health Policy Studies, University of California, San Francisco.
"Employer insurance is failing because of rapid cost increases and the inability to provide high-value care. CED's report explains that quality, affordable universal coverage is neither achievable nor sustainable unless we transform the delivery model. Health delivery systems need an independent but transparent regulatory process to achieve productivity and innovation. The CED plan is not Medicare for all, and it is not markets for all," said Dr. Jerome Grossman, Senior Fellow, John F. Kennedy School of Government and Director of the Harvard/Kennedy School Health Care Delivery Policy Program. Dr. Grossman is a CED Trustee and co-chair of the CED Health-Care Subcommittee that produced the report after two years of research and discussion by CED's Trustees and health care experts.
Key Findings of Quality, Affordable Health Care for All:
Employees usually have no choice. Insurers demand all of an employer's business to reduce per-employee overhead costs and avoid enrolling only the sickest workers. So employees have no choice of a plan (if they are offered health care at all). But employees, understandably, want to choose their doctors. Thus, to satisfy both employees and insurers, employers can offer only one plan that provides access to most doctors. The only way to reimburse any doctor an employee might choose is on a fee-for-service basis—a system with the worst incentives to drive up costs: the more services, the more fees.
Recommendations
The nation can establish such a market for quality, affordable universal health care through two key steps:
With every individual assured of quality coverage, and able to save by choosing a low-priced plan, insurers and providers would then have a new incentive to offer quality, affordable care that people not their employers want. There would be competition in the health marketplace, driven by fair rules to reward quality and cost-effectiveness, rather than denying care and selecting risks. Rules-based competition has driven progress in every other industry in our economy and around the world, and competition has the greatest promise to move health care from its current path of unsustainable cost growth, mediocre quality, deteriorating health, and declining coverage.
"This approach provides the working-age population and their dependents with quality, affordable health coverage. Expanded coverage minus cost control is unaffordable. Cost control absent a health-care market with effective competition is unacceptable. We hope that this plan will stimulate constructive debate and ultimately lead to a market-based system that focuses on the standards for effective competition where both government and the private sector can play their most productive roles," said Charles Kolb, CED President.
On May 8, 2007, the members of the Better Health Care Together coalition held a strategy summit in New York City. CED is a founding member of the coalition, which was announced on February 7, 2007 at a Washington, DC press conference. The New York summit featured a luncheon forum focused on health care reform efforts underway in California and Pennsylvania. During lunch, Governor Edward G. Rendell of Pennsylvania and Governor Arnold Schwarzenegger of California (live via satellite) addressed the coalition and guests. Both governors addressed the need for broad-based health care reform and what kind of leadership commitment it will take to achieve it.
In February in Washington, D.C., a set of four common sense principles for achieving a new American health care system by 2012 were announced. The announcement event featured the remarks of CED President Charles Kolb (view video), as well as other remarks from leaders from business, organized labor union, and public policy groups. In addition to CED, founding members include AT&T, the Howard H. Baker, Jr. Center for Public Policy, the Center for American Progress, the Communications Workers of America, Intel, Kelly Services, the Service Employees International Union (SEIU) and Wal-Mart. The campaign founders pledged to convene a national summit by the end of May and recruit additional business, labor, government and nonprofit leaders to sign on to the principles and form a wide-ranging coalition. CED has also released a new health care reform report.
A new report on the health care crisis in the U.S., The Employer-based Health-Insurance System (EBI) Is At Risk: What We Must Do About It, is now available from CED. This report presents the first two parts of CED's research and covers the scope of the crisis in health care and the options we have for fixing the system. A third part, offering CED's recommendations, will be available in October 2007.
On January 25, 2007, CED hosted a California luncheon discussion on health care reform. More than twenty business leaders, as well as representatives of leading health care providers, attended the forum which was led by CED President Charles Kolb and Lenny Mendonca, CED Trustee, and Chairman of the McKinsey Global Institute. The discussion was held at the McKinsey Global Institute office in downtown San Francisco and centered on reform plans already proposed for California and Massachusetts, as well as ways that the employer-based insurance system needs overhaul. Dr. Jerome Grossman, Chair of the CED Health Care Subcommittee, and Chairman, Lion Gate Corporation, and the CED Health Care Project Director Dr. Alain Enthoven of Stanford University, also took leading roles in the discussion.
Health care reform is a priority for CED. In 2002, CED released a detailed statement on healthcare entitled, A New Vision for Health Care: A Leadership Role for Business. In February of this year, CED will release a two-part statement on the crisis in employer-based insurance. This statement will focus on the scope of the problem and the reform options available that policymakers and business leaders will consider in making health care available and affordable for all Americans. Later this year CED will release part three of our health care statement which will offer recommendations for reform.
The United States' employer-based health care system is in serious trouble. Health care costs are again exploding at double-digit rates, the number of employees without health insurance continues to grow, and many health care services suffer from misuse, underuse, and overuse.
In CED's statement we urge employers, along with government, not only to stay the course but to actively lead in implementing specific changes in private and public policies that could produce a health care system that works for all Americans.
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This policy paper was released in Washington, D.C. on May 1, 2002. Jerome Grossman, Chairman and CEO of Lion Gate Management Corporation, and Director of the Health Care Delivery Program at the Kennedy School, Harvard University; Peter Benoliel, Chairman, Quaker Chemical Corporation; and Steve Palko, Vice Chairman & President, XTO Energy Inc. co-chaired the project.