As an Independent Philanthropy Devoted to Improving Health Policy and Practice, the Robert
In her landmark paper in Business Week titled, “10 Ways to Cut Health Care Costs Right Now,” Catherine Arnst details the multiple ways that we as a nation may cut our healthcare costs. These points share much in common with the 2009 Annual President's Message of the Robert Wood Johnson Foundation (RWJF) given by their president,Dr. Risa Lavizzo-Mourey. Dr. Lavizzo-Mourey spoke to how the Foundation's efforts will continue to further the mission of the RWJF—to improve the health and health care of all Americans—and will support progress toward the implementation of health care reform. These two reports, while dealing with health care issues, both hope to identify ways in which the United States may seek to fix its health care crisis. In her report, Dr. Lavizzo-Mourey lists 6 points in the RWJF “blueprint for change.” These 6 key points are: covering the uninsured; improving the quality, value, and equality of health care; preventing disease and promoting healthier lifestyles; bringing down spending; strengthening public health's capacity to protect our health; and addressing the social determinants of health (Lavizzo-Mourey, 2008).
As an independent philanthropy devoted to improving health policy and practice, the Robert Wood Johnson Foundation works with a diverse group of dedicated people and organizations to address problems at their roots and to help make a difference on the widest scale—particularly for the most vulnerable among us. They use their considerable resources to help impact and hopefully improve healthcare policy.
When we examine Ms. Arnst’s paper, we can see several ways that it relates to Dr. Lavizzo-Mourey’s message. For example, we can see that she specifically points out that Washington is doing nothing to address the $700 billion she estimates is being wasted on health care costs. They also do not call for changes in the underlying flaw that drives much of the waste—the fee-for-service system that pays doctors and hospitals for the amount of medical care delivered rather than for its quality. With closer scrutiny we see that doctors today are not encouraged to limit their spending because there is no incentive for them as they do not then get to keep the funds they save, instead, that money is essentially lost. This is in keeping with Dr. Lavizzo-Mourey’s position that we should bring down spending. For example, she says that our healthcare system can in fact cut spending if we ask what we canspend, rather than what it will cost. She then continues by pointing out that we can then ask how to make health care more affordable. It is unfortunate that we are not rewarding physicians for excellent care but rather how well they can spend money.
Ms. Arnst next details the fact that there is simply too much fraud and abuse in the health care system. This is similar to Dr. Lavizzo-Mourey’s contention that improving the equality of healthcare will go far in ensuring that abuses are eliminated and our healthcare spending is slashed. It is not a given that healthcare costs will continue to skyrocket if we do away with the gross fraud that is happening every day and wasting our hard earned money.
Another similarity between the two papers is that promoting a healthy work force. Paying for preventative steps now will help us eliminate costly expenditures in the future for people who are overcome with preventable disease. This is clearly reiterated by Dr. Lavizzo-Mourey when she states that we should be preventing disease with effective screening programs such as the movement to stop smoking. Ms. Arnst concurs as she points out that comprehensive wellness programs such as the one initiated by Johnson and Johnson (J&J) has cut spending on health related issues by over $225 per employee per year. When considered that J&J has 100,000 employees, the benefits are clear!
Ms. Arnst next outlines the outstanding role played by family practitioners in the maintenance of overall health. This is a magnificent point that is echoed by Dr. Lavizzo-Mourey when she says that treating illness one patient at a time does not improve the health of entire populations or communities. In other words, family doctors are in an excellent position to coordinate the extensive health care needs of some patients. They are also in a prime position for helping to control costs. This is much more cost efficient that allowing a patient to seek treatment at several different specialists without anyone to keep track of their needs or costs.
Making health a community effort is another terrific step that medicine can take to help improve spending. This is detailed by Ms. Arnst when she says that making health a community effort with undoubtedly save us money. For example, in 2005, Wegmans Food Markets CEO Danny Wegman recruited six other local employers, including Bausch & Lomb, Eastman Kodak, and Xerox, along with the Rochester Business Alliance, to set up a health and fitness program for all of the metropolitan area's 1.04 million people. The campaign, called "Eat Well. Live Well," challenges individuals to eat five cups of fruit and vegetables and walk 10,000 steps each day. More than 44,000 people have participated over the past three years, making it the world's largest wellness program (Arnst, 2009).
While both of these papers make excellent points from different directions, they share the common theme that there is no need for our health care money to be thrown away. We have the most excellent health care system in the world, and we should be able to provide care for all of our citizens. This may seem to be a daunting and nearly impossible task, but by following some of the sensible and well articulated advice of some intelligent writers before us we can achieve that very goal.
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