I don’t know about you but I continue to be amazed at the on-going dialog that is taking shape between the government and key influencers within the healthcare market. On Monday, President Obama met with health care providers to continue ongoing discussions regarding cost containment and universal coverage.

Do I think that hospitals, health insurers and pharma companies are acting in such a conciliatory manner in order to have more say in the health reform bill that will be introduced later this summer? Sure I do. However, optimist that I am, I also believe that there is a recognition from all parties that the system is failing the people and that at its current trajectory the system becomes unsustainable. Everyone, health insurers, physicians, hospitals, pharmacies, pharma companies and individuals will have to accept trade-offs if health reform is going to be successful. While I continue to think that this administration has taken the health reform discussion further than any previous administrations, the proof will be vetted out in action. What are your thoughts on Monday’s discussion?

A rather disconcerting Hewitt & Associates Survey indicates that 19% of respondents plan to drop health care coverage as a benefit over the next 3-5 years. While the survey respondents only numbered 343, the continuing undercurrent to the discussion around healthcare costs leaves little doubt that the impact of escalating costs is forcing companies to make decisions in an effort to protect corporate profitability and global competitiveness.

Health care reform is not an option it is a business imperative. The inefficiency of a massive system coupled with the lack of individual health accountability has created the perfect storm. If employers continue to drop coverage, a single payer system may end up being the only option.

“Promoting employee accountability” was ranked the chief health and prevention component of employers’ health care strategies in 2009. Employers have made significant investments in providing health services to better support healthy behaviors and mitigate acute care episodes. But that alone will not achieve the goal of employee accountability. While Consumer Directed Health Plans may shift a higher cost burden onto employees, I continue to believe that accountability has to be tied to a performance based culture.

As the economic stimulus plan hits Congress for a vote, I can not help but think about the $20B that is being allocated to creating a healthcare IT infrastructure. To be sure, it will not be perfect and there are concerns about the choices that are available in the marketplace and the interoperability issues. But isn’t it a step in the right direction? We operate in a health system that is disconnected, disjointed and frankly, dangerous. Patients lives are at risk everyday that we continue to operate in silos and off of paper based systems.

I consider myself to be a common sense and reasonable individual so when I read this article in The New York Times entitled “Groups Push for Health IT Privacy Safeguards”, I was amazed about a specific comment in the article from Senator Patrick Leahy of VT. The Senator states “If you don’t have adequate safeguards to protect privacy, many Americans aren’t going to seek medical treatment. Health-care providers who think there’s a privacy risk … are going to see that as inconsistent with their professional obligations, and they won’t want to participate.” One question: have you seen your physician’s office lately? Filing cabinate after filing cabinet filled with patient charts available for anyone to access. Let’s be real here for a moment. The spirit of HIPAA is to safeguard patient privacy not hide behind it as a roadblock towards moving our healthsystem into the 21st century. If Health-care providers think there is a privacy risk with Health IT systems, I wonder whether they understand the risk of the reems of paper that they have sitting in manilla folders on receptionist’s desks, in filing bins etc.

A recent article in the Chicago Tribune entitled Health Care Reform Talk Goes Local covers one of the many community discussions on health reform that took place over the holidays. One individual summarized the issues facing the health care system in four words: access, quality, cost and prevention while other schools of thought challenged whether the United States actually has a system. The turnout was large and well represented by actual providers of health services as well as consumers.

What I found interesting in reading this article is that there still seems to be a perception that universal coverage and socialized medicine are one in the same. It was also interesting to note that wide ranging perspectives on a market based system. While there was a wide range of opinions on the topic, a prevailing theme that seems to be taking shape is that our nation cannot continue down the current health care path. Change needs to happen and after reading multiple articles on the community sponsored health care reform discussions, I believe there is no doubt that the movement for health care reform has begun. Whether it ends with a decisively different system is anybody’s guess.

I just finished reading Senator Tom Daschelle’s book, Critical - What We Can Do About the Healthcare Crisis. It is a relatively easy read and provides a pretty clear deconstruction about how our health care system has gotten to this point of crisis. He also spends some time articulating a new model that is still based on free markets but with a more robust framework that closely parallels the Federal Reserve Board framework for our financial system. It is an interesting line of thinking and for those of us who work in the health care market, the book provides some interesting insight as to what the future Health and Human Services Secretary may be planning.

This is an interesting article regarding how hospitals may benefit under President-elect Obama’s health reform plan. would be interested in hearing your perspective on this topic.