Healthcare Reform....Buffett Style

As the debate around healthcare reform heats up there a so many different options around a better healthcare system. The ideal situation would include decreasing costs (bending the cost curve), improving access to healthcare by providing insurance to the over 46 million uninsured, redefining quality and value, improving reimbursement for preventive care, and most of all changing the behavior of the American people! How do we please all the stakeholders; patients and family members, providers, payers, employers, pharmaceuticals, and so many others?

Well, I figured that since healthcare reform involves finances and amazing intelligence, the only person in this enormous world that would have the answer would be Mr. Warren Buffett himself. The American Capitalist, the genius of investing, one of the greatest minds of this century!

So, on April 17th I had the opportunity of spending a day with Mr Buffett in his home town of Omaha, NE. As a part of my MBA education I was one of 20 or so that was able to meet with him, spend time in his Nebraska Furniture Mart, eat lunch with him, and sit down with him for a couple of hours to ask him questions about investing, life, business, finances, AND healthcare. I was the first lucky soul from our program to ask him a question.

My question was phrased as follows; "Mr. Buffett, considering that our nation is currently spending near 17% of our GDP on healthcare and having a large baby-boomer population that will soon need increased resources and financing from the system.....how do you feel we can prepare now to support these changes and who should be responsible for the funding of the system?"

This was Mr. Buffett's reply, "Well (long pause).....would you allow me to phone a friend on this one? (laughs all around)" Obviously showing that even he, the genius of geniuses, doesn't have the answer. He then stated, "Even though we need a big change, most constituents are fairly happy with how things are, so they don't want to make a major overhaul. Basic healthcare for everyone is needed, and yet we may need to ration certain levels of care; that is done financially." Last, but certainly not least he mentions something very telling, "In reality, I don't have the answer to that question. Ask me an easy question like, 'What will the stock markets do in the short-term?'"

The morals/lessons/take-aways of this story:

1. Mr. Buffett thinks that knowing what stock markets will do is a simple task compared to how do we change and finance the future of healthcare. This is not a simple task at hand.


2. Mr. Buffett believes that most constituents are "fairly happy with how things are". However, I can speak for hundreds and probably even thousands of healthcare stakeholders that we are not happy about it.


3. We must improve the system and we can't just continue status quo. We need disruptive change, not incremental and we'll all have to take responsibility....individually and together.

I have to say that in general our healthcare system is doing wonderful things. I get to witness on a daily basis the things that are being done to improve the lives of individuals. Miracles do exist, I know it (more on that in another post), BUT we have to be willing to change.

PS I still respect Mr. Warren Buffett and think he is an absolute Einstein!

Food (FAT FREE) for Thought!

As a part of reaching out to all employees and communicating the importance of what our health system, Cleveland Clinic, is doing, Our CEO Dr. Toby Cosgrove visits a different regional hospital each month. He takes the chance to explain to employees, staff physicians, and administration what strategic moves we are making, how we are preparing for the future of healthcare, and what changes needed to be made in our system and in general.

I went and listened to him speak to employees at our Fairview Hospital on the west side of Cleveland. He took questions that ranged from the role of Health IT and integration, international expansion, employed vs private practice physicians, policy changes in healthcare, AND the future model of care delivery.

As a part of discussing the future model of care delivery Dr. Cosgrove talked about two changes that need to occur in order for healthcare reform to truly "sticky".

1. We need to drive efficiency by promoting a true healthcare "system" with complete integration.
2. We must reduce and control the healthcare/disease burden.

I would like to focus on the second change that has to occur. In recent years we have seen that our nation has become one of TOO MANY wants and desires. We want things NOW and in EXCESS. Well, these things have come back to bite us. Not only is debt and financial distress increasing, BUT our weight is also increasing. Clinically there is now a new classification of obesity. In bariatrics, the "Super Obese" are individuals with BMIs (Body Mass Index) between 80 and 100. To put this in perspective a normal person has a BMI between 18.5 and 24.9, an overweight person has a BMI between 25 and 29.9 and an obese individual has a BMI of over 30 (http://www.nhlbisupport.com/bmi/). So, we are talking about 3 times the "obese" BMI. These individuals weigh in the 1,000 pound range. Obviously, the bad habits of eating too much, consuming the wrong diet, and living sedentary lives are catching up to us.

In essence, there is a huge cost that comes along with obesity and treating complications or co-morbidities that are derived from obesity, such as heart disease and diabetes. In fact, last week I was touring our Cardiovascular ORs and spoke with one of our well-known heart surgeons. He said that the amount of time and resources required to perform surgery on an obese patient is many times greater than that of our normal patient. The point is that obesity (and other lifestyle related conditions) is costing the overall healthcare system. These costs have been documented quite clearly in this article.

This article demonstrates that obesity costs the system $147 billion each year. As Dr. Cosgrove mentioned today, if we were to eliminate obesity from our nation (obviously a big goal, but dream with me here) we would be able to completely cover the over 45 million uninsured individuals through the saved costs....healthcare reform requires a "healthy change". That includes ridding the system of smoking......an issue that costs the system another $100 billion a year!!! When will we decide to live healthy lives? Time for me to stop eating my nightly dose of ice cream...self-control here I come!