Leonard D. Schaeffer, Judge Robert Maclay Widney Chair and Professor, University of Southern California
Biography provided by participant
Leonard D. Schaeffer was founding Chairman & CEO of WellPoint, the nation's largest health insurance company, and its predecessor company, Blue Cross of California, from 1984 through 2004 and served as Chairman through 2005. He is currently Chairman of Surgical Care Affiliates and a Senior Advisor to TPG Capital. Mr. Schaeffer's public service appointments included Administrator of the federal Health Care Financing Administration (now CMS); Assistant Secretary for Management and Budget of the federal Department of Health, Education and Welfare; Director of the Illinois Bureau of the Budget, Chairman of the Illinois Capital Development Board and Deputy Director of the Illiniois Department of Mental Health. He was the Regent's Lecturer at the University of California at Berkeley and is the Judge Robert Maclay Widney Professor at the University of Southern California. Mr. Schaeffer serves on multiple boards, including Allergan, Inc., Amgen, Inc., the Brookings Institution, Harvard Medical School Board of Fellows, RAND Health Board of Advisors and the National Institute for Health Care Management. He is a member of the Institute of Medicine and a founding member of the National Academy of Social Insurance.
Our health care non-system is dysfunctional in many ways. Unlike many other parts of the economy, however, it is leaderless and poorly managed at almost all levels. If we seek a rational, health care system that demonstrates basic system tenets, then we must connect all the components and establish accountability mechanisms from top to bottom. The U.S. health care non-system is characterized by confused regulation and a supply chain that controls demand. Adam Smith’s hand is not only visible, but it writes backward. Therefore, the question of who will manage health care reform is really three questions: 1. Who is responsible for the health… Read more
Comparative effectiveness research (CER) is controversial, but it is an idea whose time has come for Americans. Developing the capability to help physicians and patients understand treatment options and make the best decision is fundamental to health care reform. The most politically astute approach is to involve health care stakeholders in establishing criteria that would guide and prioritize what should be studied. The topics for a CER agenda might be narrowly focused, for example, on the most prevalent conditions, or go broader to include “systems of care” such as the concept of medical homes. The agenda should also encompass developing… Read more
Effective health care reform should squeeze everyone a little bit. Payment reform is an essential component of health care reform. Coverage expansion can only be sustained if health care cost growth is reduced. We cannot continue to reward service volume, pay lip service to better outcomes and punish efforts to produce better care at lower costs in the marketplace. The challenge will be to implement reimbursement strategies for hospitals and physicians that link payment with quality care and outcomes on a broad scale. There are many innovative strategies to correct the financial incentives that make U.S. health care unaffordable… Read more
In the best of all possible health policy worlds, Medicare, along with Medicaid and the rest of our health care non-system, would be restructured in a coordinated, integrated manner that would control costs, while improving quality and expanding access. If you think we live in that world, wait for comprehensive reform. While comprehensive reform may or may not be enacted, Medicare legislation will definitely pass for two non-health care related reasons: 1. The Medicare trust fund is running out of money and 2. Old people vote. Most elected officials face not being reelected if Medicare is not there in a meaningful way… Read more
There are three approaches to the political process of health care reform: move boldly, tread carefully or make things worse. The President has been bold. In his joint address to Congress, he was emphatic that he intends to address health care reform this year. His budget, too, is forthright in acknowledging that expanding access will increase costs (hence the notion of a reserve fund and tax increases) and that health care reform and entitlement reform should go hand-in-hand. Yet, the “down payment” strategies in the proposed budget and the health care provisions in the stimulus bill involve treading more carefully. Unfortunately, while… Read more
Assessing the odds for health care reform in 2009 is speculation at this point. What is certain is that successful health reform requires that HHS be organized and managed to inform and participate in the health care debate and to be a key stakeholder in implementing reform legislation. A recent IOM study, HHS in the 21st Century; Charting a New Course for a Healthier America (http://www.iom.edu/), identified and explored the staggering range of issues facing the agency. The most critical challenge is the need to align the missions of the many programs HHS oversees, including the CDC, FDA, NIH,… Read more
It is appropriate that SCHIP should be reauthorized and expanded to cover additional low-income children. Many children now depend on it and this group is comparatively inexpensive to insure. They and society will benefit over their lifetimes. However, extending SCHIP and expanding the use of COBRA and Medicaid for the unemployed should not be confused with or substituted for fundamental health care reform. Expanding eligibility and adding new costs for these programs will be difficult to curtail. Increasing coverage without comprehensive system reform that includes cost containment, however, will increase the speed at which our health care-driven federal deficit will… Read more
Biography provided by participant
