Mark Bertolini knows something about sustainability. According to his keynote at HIMSS14 earlier today, back in 2001, Aetna was losing $1 million a day. As with many things healthcare related, that was truly unsustainable (and hard to imagine today given their recent history).
HIMSS is the annual healthcare IT tradeshow that now attracts over 1,000 exhibitors and about 37,000 attendees. This year’s week long event is in Orlando, Florida.
In just under 32 minutes, Mr. Bertolini’s keynote outlined what he sees as nothing less than the “creative destruction” of the business of healthcare. Here is a summarized version of his speech – which started easily enough with a definition of health.
“What is health? Health is a more productive individual, who is economically viable, and is satisfied or happy. That should be our outcome. And yet our systems – here and around the world – everywhere around the world – are not functioning that way.”
“What do people want to hear when times are tough? They want to hear the truth. And so how should we define integrity. Well, integrity is based on information – not ideology. Integrity is focused on solutions not soliloquies. And finally, people want to know who’s accountable to execute – not who we ascribe blame to.”
“This is one of my favorite slides. This is how the healthcare system works. It was designed in 1945 after WW II and if you’ve ever been in this maze – and I have with my son and myself – you know how difficult it is to figure out how much things cost, where to go for care, how to follow up, where’s the office, how long do I have to wait – and it shouldn’t be this hard.”
“Now, I would argue that inside my organization today, with record membership, our largest acquisition, record revenue and this year higher profits and stock pricing than we’ve ever had – people would look at me and say why do we need to change now? It’s the perfect time to change – because the solution we need is not found in how well Aetna does – it’s in whether or not we meet that goal of healthier individuals [who] are more productive, more economically viable and that are satisfied. And when we do that with groups of individuals we solve that problem for communities and when we do it for communities we solve that for nations and when we do it for nations we solve it for the world. And until that’s done, no matter how well we do – or any of you do – it just doesn’t matter – because it’s not sustainable.”
[Referencing the 2009 IOM study which calculated that about 30% of healthcare spending is wasted in the United States.] “The number is over $800 billion – and when you solve that problem – if you were to solve it all – the United States could pay back half its debt over the next 10 years. So this should be the focus of our efforts. This should be the focus of our policy decisions, of our solutions and of our IT. How do we get at this waste?”
“Healthcare premiums are growing at four-times the rate of inflation. Currently today – through both premium sharing and benefit costs – employees are paying 41% of the healthcare dollar. If the trend line continues over the next 3-5 years – employees will be paying more than 50%.How do we break this? I’m going to give you three prescriptions for how we think about a new foundation for health.”
Date: Feb 24, 2014