The Richard and Hinda Rosenthal Lectures Spring 2001 Crossing the Quality Chasm (2003) / Chapter Skim
Currently Skimming:
Insurance, Health Benefits, and Health Care Financing
Insurance, Health Benefits, and Health Care Financing
Pages 22-31
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From page 22... ...
In that regard, I think if we can begin to move our health care system in many of the directions that are laid out in the Chasm report, it is something I and many other employment-based health plans will welcome. There are two big caveats right up front.
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From page 23... ...
The first option is not to provide that coverage. If you have not looked at the most recent Mercer Report, from 1993 to 2000, the number of employers of over 500 that are offering retiree health coverage, that is, retirees over 65, has dropped from 40 percent to 26 percent, a significant drop that accelerated even more than we thought in the late eighties when that was happening.
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From page 24... ...
I think the blueprints that the IOM has laid out, both in the first report and certainly in the latest report, set forth a call not just for improving quality, but a call for revolution in the design and delivery and the values that our health care systems promote, and I hope we will be able to deliver on that.
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From page 25... ...
In addition, and this is my favorite, we always talk about calPERS being so very big in California. We are the third largest payer for health care in California.
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From page 26... ...
The number one issue, of course, in health care in California right now is cost. Like parts of the rest of the nation, we are looking at some cost inflation coming back.
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From page 27... ...
Let me run through some key changes in the health care market, because I want to get to some comments about our current procurement payment practices. Kaiser is no longer the leader.
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From page 28... ...
When we ask them to design their own plans, to tell us how to deliver care but just simply keep it within X amount of dollars, 95 percent of the responses were cost shifting to the enrollees, which reminded me of some of the indemnity carriers in the late 1980s. The fact is that most of the strategies of the HMOs appear to go PPO.
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From page 29... ...
I will speak for myself. I have always been a little concerned about a lot of the conservative thought that wanted to move immediately to putting money in the hands of the uneducated uneducated with respect to health care and perhaps unmotivated, and expected somehow to control costs and produce better outcomes.
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From page 30... ...
I am pleased that one of the latter recommendations is that the Institute will in fact be looking at the legal reform issue as well. Finally, dissemination of best practices in evidence-based management with current competitive markets is something I would like to see the Urban Institute or the likes deal with, because I don't think we have really thought it through.
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From page 31... ...
I can tell you without any hesitation that the likes of Tom Davis at Verizon, Peter Lee at Pacific Business Group on Health, and Allen Feezor at calPERS are poised and ready to begin to try some of that from the private sector side. So we would look forward to that.
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