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The only way out of the health care labyrinth: Break down the walls

| Jun 05 2014

Every major innovation requires some level of disruption along the way. Unfortunately the U.S. health care system is such a labyrinth that we literally have to break down the walls to fix what’s broken.  For all but the simplest of health care needs, we all find ourselves at some point trying to navigate a maze of health care facilities, doctors, pharmacies, insurance companies, and government programs, with all the associated conversations, paperwork, forms, bills, and files they all require.  The labyrinth has been under construction for more than 60 years. We are destined to keep wandering around for another 60 years unless we make some radical changes.

According to the Institute of Medicine, the U.S. health care system wastes approximately $800 billion each year – about 30 percent of our health care spending. If we eliminated this waste, over 10 years we could reduce nearly 50 percent of our national debt. This problem is so significant that it affects our economy and the lives of every American. So not only is our system old, it’s expensive.

[embed_video position=”right” url=”” caption=”Aetna Chairman, CEO and President Mark Bertolini offers his vision on where health care is heading in 2014 and Aetna’s role in this pivotal year. Originally posted in The Aetna Story: 2014.”][/embed_video]

Disruption first, then transformation

I’ve seen the health care system from every possible angle – I was an emergency medical technician early in my career, a patient after breaking my neck in a skiing accident, an advocate for my son who survived a rare and deadly form of cancer, and I am a health care executive. These experiences have taught me that we need to move from a medical system designed around isolated health events to an integrated health care system that is focused on patient-centered care over the course of a lifetime. My focus and passion – both short- and long-term – is doing everything I can to help transform the system. Our first step is to creatively destroy what we have today.

We can tackle the stunning waste in health care by implementing technology solutions to reduce inefficiencies, redundancies, and administrative costs. As part of an integrated model, technology can transform health care. The work has already begun. For the past several years, Aetna has been working on aligning economic incentives between payers and providers to improve outcomes, creating a simpler, more transparent consumer experience, and advancing technologies that seamlessly connect our health care system.  All of this work is to move the consumer — the patient — the individual — to the center of the system. With a system built around the people who use it, we have a shot at building healthier communities, a healthier nation and even a healthier world.

The patient as consumer

Patients are already starting to act more like consumers, further disrupting the health care system we have today. Instead of simply agreeing to go for redundant tests or submitting to treatments they hardly understand, people are asking more questions.  Patients are more willing to ask if their doctors are sharing information and question why they have to fill out reams of paperwork at every doctor’s office. And they should be.  Not because doctors aren’t good at what they do, people should ask more questions because they have more at stake – personally and financially.

Health care may be the only place left in our lives where we tolerate the inefficiency that is hard wired into the U.S. health system. As more individuals start climbing into the driver’s seat of their own health care, I guarantee we will see greater demand for efficiency, lower costs, better tools and information and better outcomes.

If we get this right, we can create a system that keeps costs flat even as we dramatically improve the health and wellness of the American people. We can also break down the walls that make up the labyrinth we call the U.S. health care system to create a new system built for the people who use it.

(Based on remarks at the World of Business Innovation Forum, June 2014.)