The American health care delivery system is broken. Too many Americans have difficulty accessing services, and the quality of service continues to deteriorate.

Our system has become so broken that preventable health delivery system errors have risen to become the third leading cause of death in the United States — more than a quarter of a million deaths annually (almost 10 percent of all U.S. deaths) — according to researchers at the Johns Hopkins University School of Medicine based on data from the Centers for Disease Control and Prevention as published by the British Medical Journal. Only heart disease and cancer claim more lives.i

As American health care has become more deadly, it has also become extraordinarily inefficient. Not only is the cost of health insurance much too high, continuing to increase at a rate higher than inflation, but also less than half of the health insurance premium (45%) is actually spent to pay for health care services, necessary and unnecessary, a drop from 80 percent in the 1980s.

The majority of the health care premium (55%) is not spent on health care services. Rather, that money is redirected toward processing finances, litigation, compliance with regulations (that do not ensure safety, access, prevention of fraud or improvement of quality), state mandated benefits (that do not prevent, diagnose, treat or rehabilitate illnesses and injuries), and toward services never rendered (i.e. fraud).ii

When compared to the late 1970s and early 1980s, today there are more hospital delivery system errors (>14% versus <9%),iii and more hospital acquired infections (>6% versus <2%).iv In addition, physicians are spending less time with patients than they did in the 1990s, and there are more patient complaints about unexpected adverse treatment outcomes. Also, physicians and nurses are now complaining of “burn-out,” in part because of the added administrative distractions imposed by the increased insurance, regulatory and administrative burdens.

The greatest root problem with the system is that health care consumers and their physicians have been removed from the health care decision making process. Patients and their doctors lack the power to effectively implement their chosen plan for the best individualized care. Instead, the insurance companies (private and public), the corporate owners of health care organizations and institutions, and the regulatory agencies are imposing the health care service decisions – not the consumer with his or her doctor.

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The guiding principles of the HealthCare Summit are to protect and improve the health status of all Americans. We believe that the best solutions offer choice and flexibility to health care consumers by integrating the strengths of the public and private sectors.

We recognize that the American health care financing and delivery system has made some positive gains since the HealthCare Summit’s first report was issued in 2009. More Americans are insured and fewer are denied coverage because of pre-existing conditions. Also, for the first time there is a national minimum standard benefit plan which includes guaranteed issue regardless of age or pre-existing condition, evidence based chronic condition disease management programs, and wellness services. In addition, the federal government currently provides more funding for preventive services and public health population-based safety and preventive services.

But more reform is needed to curb costs, improve efficiency, and most importantly, save lives.

Our expert analysis concludes that effective reform must address and reduce skyrocketing medical care costs, and it must include transparency of medical information. It must also guarantee that all Americans have access to a “Medical Home,” coordinated by their chosen primary care physician, and it must ensure that consumers and treating physicians regain their power as the primary health care service decision-makers.

We also specify key proposals for course of action that will have the most direct positive impact in swiftly achieving the most effective reform throughout our health care system.

 

We are a NON-PARTISAN forum
of more than
100 health care professionals from across the country including experts in:

• Health insurance (with extensive underwriting, benefit design, consumer and provider relations experience)

• Health service administration
(with extensive experience managing small
and large medical groups, hospitals, and integrated delivery systems)

• Health care delivery (including primary care and specialty doctors, nurses and ancillary providers)