The cooperative principle of putting consumers first plays a major role in real health-care reform, Mary K. Brainerd, president and chief executive officer of Minnesota-based HealthPartners, told the Cooperative Network annual meeting crowd in Rochester, Minn., Nov. 14–16. Brainerd was featured at this year’s symposium sponsored by the Ralph K. Morris Foundation.
HealthPartners, the largest consumer-governed, nonprofit health care organization in the nation, experienced record growth under Brainerd’s leadership and is recognized as a national leader in the health-care industry. She attributes this success largely to HealthPartners’ adherence to the principles of co-op governance.
“I consider it a great luxury in my job to know who I’m here for, and that’s the end-user—not the doctors, not the insurance companies,” she said.
Brainerd pointed out the need for health care reform by citing figures that show, according to current trends, a family of four is likely to pay an average of $40,000 in health care costs in 10 years, yet the average income for a family of four is projected to be only $65,000. The Affordable Care Act, which was signed into law in March 2010 and is set to take effect in 2014, will extend coverage to 40 million Americans. The act seeks to make health care better and safer and provides for insurance reforms to make access easier. However, costs of health-care reform, which are to be covered by spending cuts and new revenue in the form of taxes, are concerns. Projected cuts in Medicare reimbursements, she said, are especially troubling, as a decrease in payments to doctors will negatively impact consumers by making it difficult for health-care providers to retain doctors in areas where the pay is already lower than in other areas. Brainerd added that popularity of national health-care reform continues to drop.
Key to providing real health care reform, Brainerd said, is engaging consumers in their own health by shifting the focus of health care from chronic care to supporting healthy living. Brainerd said many common chronic health concerns, such as diabetes and knee and other joint problems, are directly attributed to an unhealthy lifestyle. A healthy lifestyle—including a healthy diet, regular exercise, abstinence from smoking, and moderate alcohol consumption—could reduce health-care costs by 25 percent, she said.
Despite the physical and financial benefits of healthy living, Brainerd said only 8.6 percent of American adults and 9.8 percent of youth are now living a healthy lifestyle. Even more alarming was a series of maps tracking the dramatic increase in the number of overweight and obese Americans over the past 20 years, resulting in what Brainerd called a “tsunami of health-care costs.” Reversing this unhealthy trend is particularly challenging, she said, because healthy living is a social issue as well as medical, and no single organization can tackle it alone. She said she believes cooperatives can play an important role in leading a comprehensive social movement toward healthy living.
She is also optimistic that the obesity trend can indeed be reversed because Americans have already launched successful social movements with regard to seat belt use and smoking. In particular, Brainerd pointed out that the anti-smoking campaign has resulted in a decreasing number of smokers over the past 20 years, which in turn has reduced smoking-related health costs.
Other points Brainerd listed for achieving real health care reform include coordinating health care across specialties; making value of care the incentive for payment by taking the emphasis away from fee for procedures; using health information technology to improve results; and reducing administrative burdens.