Fourth Annual World Health Care Congress
When: April 22-24 2007
Where: Washington (D.C.) Convention Center
What: The Fourth Annual World Health Care Congress, co-sponsored by The Wall Street Journal, is a meeting of chief and senior executives from all sectors of health care. The 2007 conference includes more than 1,800 CEOs, senior executives and government officials from the nation’s largest employers, hospitals, health systems, health plans, pharmaceutical and biotech companies, and leading government agencies.
Day 2—Monday, April 23, 2007
If I could have been everywhere at once, I would have checked out the following seminars, which you may be able to get online at www.whcc2007.com. David Gergen, editor-at-large of U.S. News and World Reports, and Peter Lee of the Pacific Business Group on Health spoke about efforts to make health care more transparent and various national efforts aimed at getting doctors and hospitals to report data about the quality and cost of care. The hope is to establish standards of medical care that can be used to determine how much employers pay doctors for health care—rather than having them pay a fixed amount for every health care service delivered. This is the effort to move from a "fee for service" system to a "pay for performance" model in health care.
Instead, I went to see Craig Barrett, chairman of Intel, and Michael Critelli, chairman and CEO of Pitney Bowes, speak about their "call to action" for employers to become more involved in leading change in health care. Barrett and Critelli are particularly interested in providing digital "personal health records" that would give individuals portable, private and personal health records. These would contain all of their medical information, which they could then share with their doctors. In December, Intel and Pitney Bowes—along with Wal-Mart, BP and Applied Materials—announced the formation of Dossia, a group aimed at giving employees a way to manage their health care in a manner that would promote greater efficiency, lower costs and improved health. Barrett showed a flashy short film on the group and said the employees of the group would have a health record by the end of the year. But it is unclear whether employees will be able to access the record if they leave their companies.
Barrett, like other business leaders, bemoans the health care system’s inattention to the consumer. "Only in health care do you see concern with the internal operations of a company and not the consumer," he said.
Barrett said he could find an ATM when he visited Easter Island, 2,000 miles off the coast of Chile, but he can’t get his health records easily transferred from a hospital in California to the Mayo Clinic in Minnesota.
Barrett also said that "every major corporation I know is looking at wellness programs," including Intel.
Later in the morning, Steven Burd, CEO of Safeway and private-sector evangelist for health care reform, responded to that issue indirectly (since he was on the other side of the convention center from Barrett). "We have 300 million people in the country, and if we don’t solve the problem it’s going to be bad for companies and the American people."
Burd, who has implemented a high-deductible health plan integrated with a wellness program for Safeway employees, has a five-point proposal for federal health care reform:
1. Market-base-driven health care. This means giving employees a financial stake in their health by turning them into consumers.
2. Universal coverage and individual responsibility. This means everyone gets health insurance because everyone MUST get health insurance, just as all automobile owners must buy collision coverage.
3. Financial assistance for low-income Americans.
4. Encouragement for people to foster healthy behaviors.
5. Equal tax treatment for individuals and employers, essentially ending the preferential tax treatment employers receive to provide health care.
Burd would like the "opportunity to redesign health plans for government employees and in particular for members of Congress." He would base the plan on Safeway’s, which uses elements of consumerism, with high-deductible plans, and wellness programs that encourage employees to lead healthier lives.
Unfortunately, few doctors and hospital administrators heard what Burd and other CEOs had to say about how they want to reform the health care system. That's because most doctors were attending seminars on how to fix the health care system from their end, as medical providers. Likewise, employers, focused on their own problems with health care costs, attend separate seminars that address their specific needs. In this way, the conference reflects the bifurcation of the health care system itself.
Day 1—Sunday, April 22, 2007
Tucked inside the nation’s $2 trillion annual health care bill is a line item for conferences, of which the World Health Care Congress is among the most wide-ranging. Conference attendees represent the health care spectrum, from those who pay for medical care (employers, governments and health insurers) to those who get paid for health care (doctors and hospitals)—and all those in between (pharmacy benefit managers, disease management companies, medical product manufacturers, pharmaceutical companies and all sorts of innovators in health care).
Last year’s keynotes included President Bush, on tape, via satellite from an undisclosed location. Other notable keynotes from last year included former UnitedHealth Group chairman and CEO William McGuire, who spoke on a day last April when The Wall Street Journal (one of the conferences sponsors, no less) came out with a front-page story on the millions of dollars McGuire earned by backdating stock options. McGuire was quickly ushered out of the conference hall before reporters could ask questions.
This year, Wal-Mart CEO Lee Scott will give the closing keynote at a time when his company is under scrutiny for allegedly recording conversations between employees and reporters, as well as private shareholder meetings. Other big-name speakers from the employer community include: Craig Barrett, chairman of Intel; Linda Dillman, executive vice president of risk management, benefits and sustainability at Wal-Mart; Michael Critelli, chairman and CEO of Pitney Bowes; and Adam Bosworth, vice president, Google.
On Sunday, one of the presentations was on the Care Focused Purchasing Initiative. Like some other sessions here, this one has been touring the conference circuit since at least last year. Care Focused Purchasing is an employer-sponsored effort to pool health insurance claims data from some of the country’s largest employers, such as Boeing and Lowe’s. Claims data shows how doctors bill health insurers and thus sheds a light on the kind of medicine that doctors practice.
As employers hire companies to help manage the medical care that is provided to employees, claims information—a.k.a. data—has emerged as a new buzzword. The purpose of using data is that it helps employers analyze and understand which doctors are among the most cost-efficient and medically effective. Critics, however, say the data is limited because it does not communicate what ultimately is most important: Did the doctor make the patient healthy? This debate and many other questions that are at the forefront of today’s health care debate will play out over the course of the next 48 hours, until Lee Scott closes the conference with a keynote address Tuesday at 4 p.m.
Speaker presentations and information can be viewed at www.whcc2007.com/community.