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Robert Galvin, Interview: ‘A Deficiency Of Will And Ambition’: A Conversation With Donald Berwick, Health Affairs Web Exclusive, January 12, 2005 [Abstract] [PDF] [HTML Version] [Reprints & Permissions]

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Electronic letters published:

Health Care Change Leadership

Brian R. Klepper, Patricia Salber, Paul Dykes   ( 23 February 2005 )

Follow The Money

Brian J. Conway   ( 3 January 2007 )

Health Care Change Leadership 23 February 2005
Brian R. Klepper, President The Center for Practical Health Reform, Patricia Salber, Paul Dykes Send letter to journal: Re: Health Care Change Leadership bklepper{at}cphr.com Brian R. Klepper, et al.	We agree that, until recently, the health care industry’s “deficiency of will and ambition” has blocked the changes necessary to improve American health care. Many segments of the health care industry have been comfortably profitable and therefore have had little incentive to change. However, as public- and private-sector purchasers lose their ability and willingness to pay for coverage, the economics of maintaining the status quo become less favorable. Recent Bureau of Labor Statistics data show that the percentage of private-sector jobs with health benefits dropped by 32% over the last 12 years, with an accelerating coverage erosion rate.[1] Private-sector coverage constitutes about half of health care dollars,[2] so the current 4.5% annual decrease in private coverage translates to an approximately 2.25% annual contraction in available revenues to pay for health care goods and services – not including anticipated reductions in funding from Medicare and Medicaid. To a health care industry familiar primarily with growth, the prospect of diminishing resources is alarming. Recent conversations have led us to believe that industry leaders are increasingly receptive to change proposals as they become aware of impending market instability. It is simply in their interests. Notes 1. William Wiatrowski, Documenting Benefits Coverage for All Workers, Bureau of Labor Statistics, 5/26/04. 2. Kaiser Family Foundation, Trends and Indicators in the Changing Health Care Marketplace 2002, Exhibit 1.7, Distribution of Personal Health Care Expenditures by Source of Payment, 1990 and 2000, 5/2002.
Follow The Money 3 January 2007
Brian J. Conway, Business Development & Community Relations TDC and Company Send letter to journal: Re: Follow The Money brianjconway{at}comcast.net Brian J. Conway	Great forum and candor: follow the money, who is making the money from health care. Product providers as stated in the article are reaping most of the dollars by overselling from relationship building rather than quantifiable value-added benefits to the bottom line and improved care. There is an industry that has developed over the last 10 years that few outsiders/citizens know exists in health care: used medical equipment. Every time new equipment is purchased, the old still-functioning equipment goes out the back door, many times at 10 cents on the dollar. As is the American way, many of the new product OEMs are tied to this food chain directly or indirectly. This is where government could step up. Much of the funding for the equipment was the result of generous citizens, endowments, etc. If they only knew the number of dollars going to waste funding publicly owned entities that buy equipment at 10 cents on the dollar and resell it to lesser-endowed health care institutions for 10 times what they paid through the current system. I don't think that we make financial contributions to hospitals to benefit private enterprise. Long and short, Mr. Berwick, keep telling it like it is with candor. We can stop this leak in our boat collaboratively.