Despite deep concerns about how health care reform will actually be implemented and financed, the CEO of the state's largest health insurer said Tuesday she is "somewhat optimistic" about the overhaul.
After 35 years in the health care field, "I'm ready for something to change here," said Vicky Gregg, CEO of BlueCross BlueShield of Tennessee.
"You feel like you have been working all your career trying to make sure people get coverage, get care, and you keep in some ways, beating your head against a wall," she said, speaking during a health care forum sponsored by the American Society of Women Accountants' local chapter. "My hope is that this bill is disruptive enough that it really opens up some of those opportunities" to improve cost and care.
Two months after the passage of the controversial health care reform bill, a panel of three local speakers representing health insurers, hospitals and physicians expressed both hope and trepidation about reform's outlook Tuesday during the luncheon at the Chattanoogan hotel.
Erlanger hospital president and CEO Jim Brexler said that, at the outset of the reform debate, there was broad consensus on many principles of reform, such as the need for greater efficiency and more rational incentives for providers.
Under the current system, "if we keep you well, I don't have a job," he said. "We need to move toward a focus around wellness, education, prevention."
Local medical oncologist Dr. B.W. Ruffner, president of the Tennessee Medical Association, said he does not believe health reform tackles the major problem of skyrocketing medical spending and he worries doctors will be restricted in their decision-making by cost concerns under reform measures.
Still, he said he sees potential for health insurance exchanges to make insurance more affordable. The exchanges will be set up at the state level for individuals and small businesses, who can pool together in a large group to purchase private health plans.
"I think (they) actually drift us toward a German-type system," he said. "I think that might have some downward pressure on (medical) inflation."
In response to one audience-submitted question about whether Americans overuse the medical system, Dr. Ruffner said, "Uh, yes. Next question," to audience laughter.
Ms. Gregg added that another factor in ballooning health expenditures in the United States is the price tag on drugs, medical devices and services in the country, relative to other countries.
"I think there's a reality here that we are going to have to face. Some of it is inefficiency ... but some of it is also that the United States really does fund innovation for the world," she said. "In a global economy, we really have to begin to ask the question of whether or not we can continue to do that."
THEY SAID IT
"I'm ready for something to change here." -- Vicky Gregg, CEO of BlueCross BlueShield of Tennessee
"We spend more money at the end of life because families and society hasn't come to a realization ... that we have an end somewhere in our life cycle, and so we spend exorbitant amounts of money in intensive care units and not necessarily for quality of life, just for continuance of life." -- Jim Brexler, president and CEO, Erlanger hospital
"Physicians are not going to like it (some reform measures) because the first rule of medicine, the dream of every physician, is autonomy." -- B.W. Ruffner, medical oncologist
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