The Act of Making Care Affordable

Right now, many conversations around the country are focused on whether or not the Affordable Care Act (ACA) will be repealed. While I would hope not, I am not getting into that debate. Instead, I want to weigh in on a much bigger issue — not the Affordable Care Act — but the Act of Making Care Affordable.

As CEO of a $56 billion mega-health system that provides care and coverage for 10 million Americans, let me offer a few observations from my vantage point. High-quality care, great service, easy access, and all available at an affordable cost are the critical building blocks of our value proposition. While we have been focused on providing high-quality and affordable care as part of our mission for nearly 70 years, the question of affordability has become even more critical for our organization and every other health system in this country that is paying attention.

The rising costs of health care have been shifted to consumers, who are now asking very different questions and expecting more for their health care dollars.

Let me offer a few data points. From 1999-2014, overall inflation increased 43 percent, with workers’ earnings increasing 54 percent. Health insurance premiums went up 191 percent. Contributions made by employees to premiums increased 212 percent! Conclusion: employees have not felt the benefits of a real wage increase, because the additional dollars earned have been used to pay for health coverage and care.

As of 2013, household spending for housing, utilities, fuel and furnishings was 26 percent. Health care spending, at 23 percent, came in second only to paying for the roof over your head, and was significantly more than transportation and food. Now you can understand why some consumers need to make trade-offs between putting food on the table and taking care of their health.

This is, in part, one of the reasons the Affordable Care Act (ACA) became law — because health care is unaffordable and millions of Americans were shut out of the front door of the health care system. But the ACA is only a start of the transformation of health care. I offer that in addition to coverage, the health care delivery system should be reformed for greater affordability. At no time should a choice be made between quality or affordability. Quality is non-negotiable — and high-quality health care leads to greater affordability.

The public outcry for health care reform by both consumers and employers is a legitimate demand. The fact that we are trying to offer every person in America health care coverage and care is not the problem. The crux of the issue is figuring out how to design a health care system that delivers both sick care and prevention, leverages 21st century technology, shares best practices based on data, and creates new and innovative ways to care for the wonderfully diverse populations we have in this country. We need to deliver value in the form of good health care and coverage at a cost that allows consumers to have money left to use for other areas of their lives.

As we recognize the five-year anniversary of the Affordable Care Act, we can be proud that we have begun the journey toward better health for more Americans. Now we need to act to make care even more affordable. It will take the entire industry working together to deliver on our promise of better health for all. I remain optimistic and committed.