U.S. Health-Care System Is Out of Balance, EmblemHealth CEO Says



how concerned are you about the next phase of what president Truong wants to do I think the most important thing is to step back and for us to have a broad discussion about the future of healthcare which is happening organically in the political arena anyway and I think it's this what we're doing bonnie is going back and forth what is the role of government that underlies the whole discussion and that's a fine and actually a fair question to debate for us in the healthcare sector it's important for us to step forward and demonstrate what we're doing why we are worthy of the trust of the American people what we're providing how we're providing access and what we're doing to reform restructure and transform the health care industry which is what I think consumers want to hear sure that's all very well and good but if Congress decides to do something or if as the president says all three branches you know legislative executive and so on well how will be in Republican hands next time around then doesn't matter what the health care sector is doing won't it be legislated well I think that we have seen some legislation thus far we've seen some regulation and it's important for the sector to respond to that we've responded to that we've put affordable products in the market people have responded to that there's a little bit of an overhang however with respect to the ACA are people required to participate as health plans we are required to make our product available but we're seeing now some people not participating which has an impact on cost and that is to say some of the younger and the healthier people are beginning to not necessarily participate and that forces the cost up for everyone that's a discussion that we will have in the context of the upcoming forthcoming presidential campaign but it's important for the industry to step forward to say what to do about that states have stepped forward New York State has stepped forward New Jersey Connecticut other states are stepping forward and actually filling that gap and defining those answers so you're actually the largest not-for-profit insurer of sending three million in the tri-state area so what are you saying then what we're saying is it's important to step forward and provide some opportunity to give people a roadmap some of the things that we what does any of that mean what it means is that it's important for people to understand that there is a route to reducing costs it's to get everyone in to have the younger and the older people involved in a pool that actually puts the cost where it should be it balances them right now we're a little out of balance and I think that's what states have done in certainly New York State and Connecticut New Jersey in our tri-state area they are wrestling with this very productively which is very good and where our job is to provide the information and the data to give them a roadmap for what they can do to solve some of these problems it's me though that you are bound by what the legislation is so if there were to be for example an abscessed you know and one of the more left-leaning democrats were to win the presidential election next time then you would be looking at something very very different right you might even be looking at you know a radical overhaul you can always be in the future looking at something very different and our job is to respond to the here and now and prepare for the future whatever the externalities might be and that's what we're doing we're putting products in the area to actually change the focus to put the focus on value in the healthcare system as opposed to volume we've had a fee-for-service system so it's been a piece rate system we're switching that we're changing that and we're working with our provider partners to do that so is there anything wrong with the ACA as is well the ACA was laid out to actually get more people into the system and it did accomplish that some of the recent changes in Congress have made it more difficult for individuals to actually achieve that objective and so what states are doing is they're stepping forward and looking at what they can do to ameliorate some of these impacts and that's where we are right now now what happens per your question in the future is quite another thing entirely and nobody really knows what's what we have to deal with is the here and now prepare for the future and bring into the delivery system a way of getting the most people in getting the cost down and improving the quality it's that triangle of issues and drug pricing that's drug pricing is a very significant challenge without a doubt the prices are too high and at some point we have to have a more direct discussion about what is driving those prices why are they so high and what to do about it and one of the things that worries me is that we're talking around that and talking about everything but the fact that the prices are too high they're being set too high and and the political system I think will get to a very robust discussion around that

2 Comments

  1. This lady is a super politician, but I guess she is a product of society's severe social strains on women leaders.

  2. She is a robot

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