Healthcare Experts Discuss the Drive for Reform

As healthcare reform continues to be a major topic of conversation in Washington, D.C., two leaders in studying ways to improve care delivery and insurance coverage in the country came to SOM on February 5 for a special discussion jointly hosted by the SOM Leaders Forum lecture series and the Yale MBA for Executives: Leadership in Healthcare program. To Dr. Ezekiel Emanuel, head of bioethics at the National Institutes of Health and a special advisor on healthcare policy for the Obama administration, and Michael Porter, Bishop William Lawrence University Professor at Harvard Business School, improving healthcare requires wholesale changes to the system itself. "Getting universal coverage and access is essential, but it’s not the end of the challenge — it’s the beginning," said Porter. "We can’t make incremental improvements. The entire system is broken."

Both Emanuel and Porter have studied healthcare delivery for many years,. Each has become a respected, if controversial, proponent of enacting comprehensive reform. While Porter focused on specific ways to overhaul the system, Emanuel spent much of his time at SOM establishing just how bad things are — and how much worse they’ll get in the future if nothing is done. He noted that the $2.5 trillion spent on care in the United States last year is almost double the personal consumption of everyone in China. Without real reform, he said, that number will only continue to increase, creating a catastrophe for the nation. "By 2082 there will be only two kinds of people," he said. "Healthcare providers and patients. That’s the trajectory we’re on if we don’t change anything."

Emanuel and Porter believe there can be substantial savings if key changes are made. Porter argues that the focus needs to be on increasing value for patients, which will force major improvements to the system. Emanuel noted that 20 % of the population is responsible for 80 % of health care costs. Much of that number results from chronic "lifestyle" diseases such as diabetes and smoking-related ailments. Major savings can be seen if doctors are able to get patients to take better care of themselves. "But that’s the hardest thing to do," Emanuel said.