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A Broader View of Health Reform KSNA Annual Day at the Legislature February 9, 2012

A Broader View of Health Reform KSNA Annual Day at the Legislature February 9, 2012. Robert F. St. Peter, M.D. Kansas Health Institute. Objectives. Understand the case for reform Put ACA in context of needed reforms If not the ACA, then what? Q&A.

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A Broader View of Health Reform KSNA Annual Day at the Legislature February 9, 2012

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  1. A Broader View ofHealth ReformKSNA Annual Day at the LegislatureFebruary 9, 2012 Robert F. St. Peter, M.D. Kansas Health Institute

  2. Objectives • Understand the case for reform • Put ACA in context of needed reforms • If not the ACA, then what? • Q&A

  3. The US has the best health care system in the world

  4. The US has the best health care system in the world True or False?

  5. The Case for Health Reform in the U.S.

  6. International Comparison of Spending on Health, 1980–2008 Total expenditures on healthas percent of GDP Average spending on healthper capita ($US PPP) Source: The Commonwealth Fund, OECD Health Data 2010 (Oct. 2010).

  7. How Good is Our CurrentHealth Care System? • Access • Satisfaction • Costs • Quality of Care • Outcomes • Medical care • Health status • Efficiency • Value

  8. US Health Care System Compared to Others • Access • Satisfaction • Costs • Quality of care • Outcomes • Medical care • Health status • Efficiency • Value ?

  9. WHO Rankings of Health System Effectiveness (2000)

  10. What Is The Goal ofReform Efforts? Improve Access or Reduce Costs or Improve Quality

  11. What Is The Goal ofReform Efforts? Access, Cost, Quality or Improve Efficiency

  12. What Is The Goal ofReform Efforts? Access, Cost, Quality, Efficiency or Improve Health?

  13. What Should We Reform? Health Insurance System or Health Care System or Health System

  14. Three Primary Components of the ACA

  15. Cost Containment, Payment Reform and Delivery System Change

  16. Why U.S. Spending is Higher Source: McKinsey Global Institute, “Accounting for the Cost of Health Care in the United States”, January 2007

  17. Source: New England Health Care Institute, Waste and Inefficiency in the U.S. Health Care System, Feb 2008

  18. Public Health

  19. What Determines HowHealthy We Are? Social Conditions15% Genetic 30% Environment5% Health Care 10% Behavior 40% Source: McGinnis JM, Russo PG, Knickman, JR. Health Affairs, April 2002.

  20. Where Does the Money Go? Robert Wood Johnson Foundation, 2000

  21. Reform versus Transformation • REFORM: Redirection of spending within health care to – • Primary care, prevention, medical homes • Effective treatments, EMR • Population-based programs • TRANSFORMATION: Redirection of spending outside of health care to – • Child and youth development and education • Economic development/poverty reduction • Promotion of healthier homes, neighborhoods, schools and workplaces

  22. What’s the Hurry? Source: Congressional Budget Office, “The Long Term Budget Outlook”, August 2010

  23. For More Information See the KHI website: www.khi.org

  24. Kansas Health Institute Information for policymakers. Health for Kansans.

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