Hot takes from health leaders: “Who needs to fix the affordability crisis?”
Healthcare affordability won’t be solved by people who all think alike. It won’t be solved by staying in our ideological corners, repeating the same arguments, or waiting for someone else to act.
It will be solved by leaders willing to speak honestly and directly, even when it’s uncomfortable.
That’s the spirit behind Hot Takes from Health Leaders: a biweekly series featuring candid responses from the policymakers, clinicians, hospital executives, researchers, and advocates who will convene at LOWN26: Confronting Healthcare Affordability on May 21st in Cambridge, MA.
Because before we can find common ground, we need to know where everyone actually stands.
New installments published every two weeks leading up to LOWN26. Join the conversation on May 21st—register now.
Early registration for LOWN26: Confronting Healthcare Affordability ends March 10!
On May 21st we’re convening policymakers, clinicians, hospital leaders, business executives, and union organizers, united by one conviction: care shouldn’t crush the finances of American families. If you want to shape the future rather than wait for it, this is the conference for you.
This week’s question for our guests: “Who bears the greatest responsibility for fixing the affordability crisis? Who’s getting a free pass?”
Policymakers are in the driver’s seat
I am afraid it will take regulatory action to address [affordability] because the market itself has proven it is ineffective in moderating health care prices. We are seeing more pressure from employers who are having a tougher time managing the high cost of employee health coverage. Absent federal leadership, we are beginning to see more aggressive actions by states to enact price caps on various components of the health care system.
Fred Cerise, MD, MPH, President and Chief Executive Officer, Parkland Health
Policymakers have a significant responsibility in fostering systems that allow for truly meaningful affordability.
Reshma Ramachandran, MD, MPP, MHS is an Assistant Professor, Yale School of Medicine
The state and federal government bear the greatest responsibility as the healthcare system is highly consolidated and riddled with opacity. Everyday people and employers could compare prices per service/procedure if price tags for all procedures were required to be accurate, understandable, and readily accessible. The Group Purchasing Organizations (GPOs) affiliated with the largest healthcare conglomerates whose headquarters are located overseas are legally getting a free pass, unfortunately.
Gloria Sachdev, PharmD, Secretary of Health and Family Service, State of Indiana
Hospitals and doctors need to step it up
Organized medicine could play a bigger role in advocating for a system built for affordability rather than profit.
Brian Campbell, PhD, Executive Director, Physicians for Social Responsibility
Employers state that hiring more nurses is costly to hospitals and that there is a shortage of nurses in the U.S. We have graduated more nurses in the U.S. in the past decade than in the past three combined. The issue is not that we have a shortage of nurses in the U.S., but rather nurses don’t want to work in hospitals that understaff the units. Hospital employers are accountable to hire a safe number of nurses in their hospital rather than staffing thin at the margins to cut on labor costs. Evidence shows that investment in safe nurse staffing is an investment in higher quality care for patients.
K. Jane Muir, PhD, MSHP, RN, Assistant Professor of Nursing, University of Pennsylvania School of Nursing
The efforts to make changes in any dysfunctional system are often initiated by passionate, everyday people. Making healthcare affordable needs a movement that everyone could get involved in. As physicians, we should definitely be involved with learning more about many of the different aspects of our current system’s dysfunction. We have all seen how awful denied or delayed treatment is, especially when there is a cure or treatment known. As healthcare providers we need to be involved whether we are seeing patients, doing research, or working in a healthcare related field. This is literally life or death.
Susan Rogers, MD, Immediate Past President, Physicians for a National Health Program
Systemic change is the key
The belief that adding more bureaucracy to Medicaid, through tighter eligibility rules, additional administrative layers, or increasingly complex oversight, in order to reduce costs for consumers or overall system spending is, in my view, overrated. In many cases, these strategies create barriers that lead patients to delay care, which ultimately drives higher downstream costs for the health care system.
Too often, policy debates focus on incremental fixes onto a structure that was never designed for affordability or simplicity. Imagine the costs associated with billing, prior authorization, eligibility verification, contracting, and navigating multiple payers. This friction adds cost without adding better outcomes. Safety-net health systems experience this most acutely.
The real opportunity lies in simplifying how care is delivered and paid for, by aligning incentives, minimizing unnecessary barriers, supporting coordinated care, and allowing safety-net systems to focus resources where they have the greatest impact: improving health outcomes and advancing quality of care.
If I could wave my magic wand, I’d say we need to build a new system, that’s the policy solution we need. We are wasting a lot of time and money on patching up a system that people are fighting about whether it even works.
Donna Lynne, DrPH, Chief Executive officer, Denver Health
The affordability crisis is a direct and inevitable consequence of the fragmentation within our system. This can only be solved with a national solution.
Ed Weisbart, MD, National Board Secretary, Physicians for a National Health Program
The power is in all of our hands
All of us. Everyone that touches healthcare has a role to play. In regards to getting a pass, I think all parties have work to do, and before we cast concern, we all need to continue to seek improvement in our own environments.
Jason Carter, MBA, President and Chief Operating Officer, Duke Regional Hospital
Ultimately patients and workers are abdicating their massive power and hoping that new technologies and politicians will save us. They won’t.
Andrew Goldstein, MD, MPH, Assistant Professor, Department of Medicine at NYU Grossman School of Medicine