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Kai Ryssdal: While Congress is getting tutored on health care, the White House has been holding its own informational meetings. Over the past couple of months President Obama has met with health-care groups and executives to talk about what he wants to get done. The pharmaceutical industry has been to the White House. Doctors’ groups. And insurers, of course. The CEO of one the biggest non-profit health-care systems in the country has been in on those consultations, too. George Halvorson of Kaiser Permanente. When we spoke earlier this week, he said the media missed the point of the White House meetings. That the real discussion this time, behind those closed doors, is about changing the way care is delivered. Not about the cost.
GEORGE Halvorson: That’s one of the really fascinating things about this wave of reform. Because in the Clinton era, people were talking about reconfiguring the care delivery system. This most recent reform has been more heavily about cost savings. And the president has said repeatedly that he wants higher-quality care, better care, and wants to get to the right outcome by making care more affordable by making it better. But the debate has gone off track from that point.
RYSSDAL: Let me pick up on that point for a second. We had on the day of the president’s press conference last week, we had David Leonhardt on from the New York Times. And he had written a column about health care, and why it’s so tough to figure out. And his lead question was, people don’t understand what’s in it for me. And that’s a theme the president picked up on Wednesday night. So I want to flip that around and I want to ask you as a representative of the health-care industry at large, what’s in for health care to get this reform going?
Halvorson: What’s in it for health care is if we can cover everyone in America, we can do a much better job of taking care of people. Right now, a majority of kids do not get right care for asthma. And because kids have coverage, and they lose coverage, they go to a care site, they go to a different care site. There’s no feedback from the emergency room to their primary care doctor. There is no consistency in asthma care, and that can’t be fixed until the kids have continuous coverage and a continuous database. So if we’re really going to fix care, we need everyone covered.
RYSSDAL: Universal coverage, that’s your step one.
Halvorson: Universal coverage. Yeah. We need coverage for everyone in America.
RYSSDAL: So how do we get from where we are right now to universal care? How do we do that?
Halvorson: We need to do a couple of things. One of them is we just need to make sure we expand Medicaid to cover all low-income people, whether or not they’re parents. We need to make sure there’s intermediate subsidized care for middle-income people. We just need to make the commitment. Every other industrialized country has done it. And most of them do it with a double mandate. Everyone must buy coverage, and every insurance company must sell it.
RYSSDAL: Isn’t it time, though, perhaps to get our brains around the fact that if we’re going to do that, at some kind of reasonable cost, then everybody can’t have all the care they want.
Halvorson: I don’t think that’s true at all. The issue is not that we need to ration care. We do not need to ration care. Right now, when you look at diabetes, 32 percent of the cost of Medicare is diabetes. It’s the number one cost of blindness, it’s the number one cause of amputations, it’s the number one cause of kidney failures. And when you look at the care delivery patterns in America, we only get care right for diabetics 8 percent of the time. If we got care right for diabetics 80 percent of the time, we’d cut the number of kidney failures in half.
RYSSDAL: At the end of the day, are you hopeful or not that this time around we’re going to get some kind of change to the health-care system done?
Halvorson: I’m extremely hopeful. I am extremely hopeful, I’m optimistic. I think that there are a lot of people pointing in the right direction. I think we haven’t figured out the specifics of what the right direction is yet. And that works need to be done. It needs to be done quickly. But I’m basically very optimistic.
RYSSDAL: You’ve been following the terms of the debate, right? You’ve been reading what’s going on.
Halvorson: Yes. Very directly.
RYSSDAL: And you’re still optimistic?
Halvorson: And I’m still optimistic.
RYSSDAL: I have to ask you where that’s coming from.
Halvorson: It’s coming from a belief that we have to get it right this time.
RYSSDAL: George Halvorson. He’s the CEO of Kaiser Permanente. Mr. Halvorson, thank you so much for your time.
Halvorson: Thank you for having me on the show.