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If you've been living under -- -- you heard -- the decision and we all waiting for is in and the country is moving forward with the president's health care law.
The president says that this is gonna make health care cheaper for everyone.
Not really sure about that so we joining me now is an all star panel of health care experts.
Director Deloitte center for health solutions doctor Toby cost -- CEO of the Cleveland clinic.
And then hand back president of the hand backed group which is an independent health insurance brokerage firm gentlemen.
-- you so much for joining me to answer our questions tonight.
-- -- With -- and we're talking about fifty million more people we're gonna have health insurance that's gonna cost about 34 point seven billion dollars those are CBOs doubts.
Who's gonna pay for that does that mean higher premiums -- thing.
Yeah I think one thing that the American public and American businesses don't recognize.
What's been taking place over the past twelve months is that there's been over a billion dollars.
Going to that individual states to set up these state exchanges.
And this is where the individuals that either don't have coverage -- their company.
Or do not have coverage are gonna go to purchase their insurance and I've had a peek behind the curtain with these exchanges.
And the exchanges are limited networks so those providers in those hospitals that they go to is going to be limited.
Which I think at the end of the day might be a little less expensive because that's what -- they're trying to accomplish but it could compromise the quality of health care.
Paul what do you think about that does that sound like what's going -- Well not exactly.
Think the the way the exchanges plays out is still to be determined we only have fifteen states that a vindicated what they're gonna do we've got thirty that have yet to even.
Indicate what their blueprint is gonna do.
As doctor 'cause drove knows well neural networks that perform well may be advantageous so.
I think it's too early to determine.
What the cost impact is of the Affordable Care Act in total.
And even within these narrower bands of health exchanges or what preventive health might produce and other things.
OK Paul that -- time bring it back to an individual level or excuse me let me go to doctor prosper because -- even given him a chance yet that.
What -- think this means for an individual who buys insurance right now you have insurance and you like it says the costs go up based on what happened today.
Well I don't think we're able to tell exactly you have what's gonna be the cause of this it's -- -- be dependent there what's the results going to be it's gonna depend upon how -- Effective we aren't taking down the cost of providing that care.
Over a period of time I mean we've been working very hard.
Take that cost down over very long period of time.
I think that as we begin to get health care more coordinated.
And put more emphasis on preventing chronic diseases.
I think we will bring the cost down but I'm not sure that we know yet what the -- on the whole nation is going to be or the individual.
-- if we are working for a long time to bring the cost and we haven't -- a very good job cuts costs are rising at a dramatic rate what we do to bring costs down.
Yeah cost cost -- risen you know specifically over the past couple years because of the changes in the health care law.
The you know the addition of it -- children age 26 the lifetime maximum and preventive care so insurance companies and consumers have seen that increase already.
One thing that.
The health care reform act doesn't address is one of the bigger issues with.
With America right now it's lifestyle choices.
Paul what about that.
Well I think.
-- does some things that are intended to bend the cost curve it eliminates.
Co pays for preventive health services.
Covers a variety of essential health benefits which treated early could for crude that -- event but.
I tell -- before trying to bend the cost curve.
Without compromising safety and quality.
That are really boils down to some very straightforward things one is we need to shift the incentives from fee for service.
Two performance to safety and outcomes and quality and efficiency.
Two we need to leverage technology so that we.
Take waste and fraud out of the system and so we rewarded here it's.
To the evidence three we actually need to make evidence the standard for what we pay for instead of kind of field of dreams health care where we do what we can and get paid to do more.
And lastly we -- -- -- aggressively address behavior modification Toby is.
Champion of this 75%.
Of the cost in this country has its root cause in unhealthy lifestyle.
Now those four.
In the in aggregate.
Can bend the cost curve we still have a problem.
To take care of about 5% of the population that are severely.
Disabled have very difficult medical conditions but.
For most of the population if we got very serious about delivering that kind of health.
We could bend the cost curve.
-- -- -- -- -- I -- -- back to just that it you know that the level that's right in front and asked me if we -- fifty million people to the system.
We already have a doctor crisis from your experience do we have the doctors deserve all these people right now I mean does the quality of care you're trying to quality of care -- the quality of your guard down immediately.
Well clearly we're -- -- organized.
How to care delivery group in a different way we're gonna have a -- shortage -- about 90000 doctors across the United States.
Now what that means is we're going to incorporate.
More mid level providers more PA's -- -- to begin to help us.
-- care for this very large population.
Now that is not necessarily a bad thing that does it increases the efficiency and that allows everybody to practice at the top of their -- -- And it analysts doctors do doctor work and not so much of the other stuff that's more frequently called on to do so I think I think there while we're gonna have a shortage of doctors.
And a lot more patience and and we are going to reorganize ourselves and who actually delivers the care and by the way.
The church continues right around in the nurses we're gonna have a shortage of a million nurses across United States.
And those are going to be replaced by technicians all of which.
Help us make a more efficient delivery system across the country.
-- we talk about shortages mean one thing we always have is a shortage of money to pay for all of this our employers gonna end up paying more and as a result -- they just hire fewer workers.
I think you're gonna see.
A couple things I think you're gonna see some employers dig their heels in the ground.
And slow down the hiring process and the other thing is they're gonna be making that decision.
Do I provide insurance to that group of employees that that I don't -- currently can have covered.
And pay the penalty the current cost right now for health insurance to an employers -- were between six and 8000 dollars and that.
That 2000 dollar penalty to -- awful attractive especially -- high turn over or if your -- facing financial struggles.
All right gentlemen thanks so much for joining us -- --