What is the Truth About the Cost and Utilization of Medical Technology in Europe vs' the U'S'

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What is the Truth About the Cost and Utilization
of Medical Technology in Europe vs. the U.S.?

• Robert Laszewski
• North American Chair
• The Global Medical Forum Foundation

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Americas Healthcare Costs Continue to Rise

• Five straight years of 10 to 15 increases in
  private health insurance costs.
• Kaiser Foundation survey estimates cost of family
  insurance is 9,950 in 2004.
• At just a 7 health insurance cost trend, family
  health insurance would cost 14,000 per family in
  five more years.

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Do We Have the Answers?

• 11 of employer benefit managers think
  consumer-driven strategies will be very
  effective42 think they will be somewhat
  effective. (Kaiser Foundation Employer Survey)
• 15 of employers think disease management
  strategies will be very effective in
  controlling costs. (Kaiser Foundation Employer
  Survey)
• CBO studied Medicare disease management
  experiences and concluded savings might not be
  attainable and the program could even raise
  costs.

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Most of What Has been Proposed or We Will Do is
Inflationary

• The Kerry Plan.
• The Bush proposals to expand coverage.
• The new drug benefit.
• All these proposals expand coverage and ignore
  the real issue.
• The real issue is Cost.

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The Cost Containment Proposals At Hand Will
Hardly Contain Cost

• Drug reimportation.
• Medical malpractice reform.
• Small business pooling.

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The American Healthcare System May Be the Biggest
Supply-Side Economy in the Universe
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The optimal supply of hospital beds needed by
each country, for planning purposes, has been the
subject of study and debate everywhere. If there
is an assured system of payment, it seems that
almost any additional hospital beds provided will
tend to be used, up to a ceiling not yet
determined.Health Economist Milton Romer -
First Postulated in the 1960s
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Perhaps the Biggest Driver in the American
Healthcare System is its Unfettered Ability to
Simultaneously Increase Supply and Price. Until
We Are Willing to Confront That We Are Just
Frittering Around At the Edges
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The American Health Care Financing System is on a
Long Walk Off a Short Pier
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Americans Are Not Ready For Change (Ayers
McHenry Poll for AHIP).

• For all the cost-shifting the American
  middleclass is not hurting enough to demand
  solutions.
• Healthcare was the fifth most important issue on
  Election Day6 of voters said it was the top
  issue.
• 83 of voters said they were satisfied with their
  existing health insurance coverage.
• 82 of voters said the health care system needs
  either significant changes or a fundamental
  overhaul.

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What Will Happen When the System Finally Goes
Tilt?

• When employers either drop coverage or shift
  costs to the point the middleclass makes
  healthcare the top domestic issue.
• When individuals have no affordable alternative.
• When politicians begin to look for expedient
  solutions.

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Over the Next Few Years

• In the short run public will remain relatively
  ambivalent to rising costs.
• Costs will continue to escalate at unacceptable
  levels.
• Employer cost shifting and the dropping of
  benefits will escalate.
• The baby boomer pressure will grow.

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The Next Few Years

• In the face of huge trade deficits, the resulting
  likelihood of a falling dollar and inevitable
  inflation, healthcare costs will become a more
  important problem for Americas global
  competitiveness.
• During this walk on a short pier frank
  discussions and good faith efforts to find the
  real answers must happen.
• We will either be ready with real solutions or we
  will deal with the inevitable political
  expediency when the critical point is reached.

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Frank Discussion and Good Faith Efforts Are Why
We Invited You Here

• The GMF takes no policy positionit is an
  objective forum for discussion among healthcare
  leaders from more than 30 nations.
• We dont know what the answer is.
• We believe there are no borders on the lessons
  that must be examined.
• It is likely that any American solution will be a
  uniquely American solution.

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At the GMF

• There isnt any one cause or any one solution.
• This should not be a simplistic debate about
  market versus government management.
• Wherever the facts take us

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Our Process Today

• Four keynoters uniquely able to speak to their
  systems management of technology and the impact
  that has on their citizens.
• American panelists with hands on experience
  looking for lessons.
• Is there anything in these experiences that can
  be helpful to what will be that uniquely American
  solution?

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Kaiser Family Foundation Webcastwww.globalmedica
lforum.orgGMF IVZurich April 4-6
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So Lets Begin