Slaying the Three-Headed Dragon Known As Health Care

ORLANDO, Fla. - Trying to reform the nation’s health care system is like trying to slay a three-headed dragon.

That’s according to David Grunke, speaker and coach with the Grunke Group in Madison, Wis. Grunke is scheduled to speak today on “Federal Health Care Reform: 2017 and Beyond” at the National Association of Health Underwriters annual convention.

The three heads on that health care dragon? They are money, emotions and what Grunke called “we insist.”

First, the money. Health care takes up 17 to 18 percent of the U.S. economy, Grunke said, compared with 10 percent of the gross domestic product of most Western nations. That large percentage of the economic pie is one reason that health care reform is so complicated.

Almost everything involving health care has an emotional component to it, which further complicates reforming the system, Grunke said.

And then there is the “we insist” part of health care.

“Who is the ‘we’ that ‘insists’?” Grunke asked. “It is the Senate. It is the House of Representatives. It is the president, it is the Department of Labor, it is the Center for Medicare and Medicaid Services, it is the Department of the Treasury, it is the American Medical Association, it is the American Chiropractic Association.

“We have a whole lot of people who are insisting on what health care reform should be. The more people you have at the dinner table, the harder it is to serve the meal that everyone would want.

“So health care is a ton of money, everyone has a piece of the action and everybody insists and everybody has right and good reasons why they insist, and it’s emotional.”

Grunke also discussed the process of bringing a health care reform bill into reality.

“We have a bill passed by the House and I believe we will have a Senate bill by the July 4 recess,” he said. The Congressional Budget Office will have to score the Senate bill and then a vote will be taken. From there, both the House and Senate bills will go to a committee before going to President Donald Trump for a signature.

But if health care reform doesn’t happen through the legislative process, it could come about administratively, Grunke said. The Affordable Care Act contains about 3,000 provisions that are at the discretion of the Health and Human Services secretary, Grunke said, and that opens the door for the Trump administration to change the health care act without the approval of Congress.

Grunke also will address the factors that drive up the cost of health care. They include the cost of disease, the cost of drugs and the cost of behavioral health. In addition, he will look at emerging care models – everything from the consolidation of medical practices and hospitals, to the trend of hospitals owning health insurance companies.

Changes in care delivery systems also drive the cost of health care, he said. Over the years, the trend in health care has been to move consumers from inpatient facilities to outpatient facilities. Now consumers are moving from outpatient facilities to physician’s offices, specialty care facilities, worksite medical clinics and even retail stores such as Walgreens.

Susan Rupe is managing editor for InsuranceNewsNet. She formerly served as communications director for an insurance agents' association and was an award-winning newspaper reporter and editor. Contact her at Susan.Rupe@innfeedback.com.

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