Advancing Health Care Reform | Improving Members' Lives | Improving Access | Thought Leadership | Improving Cost and Quality | External Resources

Ron Williams, Aetna Chairman and CEO: I want to thank everyone for taking time to join us this morning.

Narrator: As part of Aetna’s ongoing effort to promote dialogue and act as a thought leader in the health care industry, the company recently sponsored a forum for policy experts, legislators, providers and employers.

Participants at the Aetna Foundation Health Policy Forum on Transparency and Choice in Health Care explored how transparency is affecting the system, how it promotes quality and the potential of transparency to transform health care.

Ron Williams: We do believe that consumers are going to end up paying more to access health care services than they did in kind of the golden age of managed care when it was $5 for an office visit. And they’re going to be asked to participate more both as a patient as well as a consumer in health care.

Carolyn Clancy, M.D., Director of the Agency for Healthcare Research and Quality: I can stop any conversation with most members of my family, all of whom are highly educated, and lots of friends, by asking one question, Why? When they say I'm going for an MRI, I'm going for a CAT scan, I'm getting this test and I say, well, why are they doing that? There's this long pause. Why? I don't know; the doctor said I should go get a test. The idea that they are part of the treatment process hasn't quite sunk in, so I think we've got a big job ahead of us.

Nancy Nielsen, M.D., Ph.D., President Elect, American Medical Association: It is time for insurers and physicians to quit meeting each other in court. Let's start cooperating. If we do that with the patient and the improvement of quality for the patient as the basis of that cooperation, then the country stands to gain.

Narrator: The goal is to bring together multiple constituents to transform the health care system.

Carolyn Clancy: We're going to be chartering 25 or 30 local communities who have shown that they either have a track record or a commitment to working with multiple stakeholders. And, they will be chartered to report publicly on information initially about physician performance at the group level.

Narrator: While privacy concerns are certainly critical, the potential for sharing data to help improve the quality, safety and efficiency of health care cannot be overlooked.

Mary Grealy: Both of you really highlighted the importance of broader information sharing, and yet, at various Congressional hearings, there have been privacy groups that have said we should limit information sharing even if its de-identified, that we can't de-identify information enough. How do we meet their challenges?

Carolyn Clancy: They're a relatively small proportion of the population. I think they get a lot of air time in policy discussions, and that's good because they will remind us about how important trust is.

Nancy Nielsen: This debate is going to be a very intense one. There will be tradeoffs.

Carolyn Clancy: I think we need to create systems people can opt out of if they want. And they can opt out either entirely or on a selective basis. And, I think that's going to be challenging. In addition, I think that figuring out who are the intermediaries and trusted sources are for some of this information is likely to be very, very important.

Nancy Nielsen: So, as long as we have people whose health information could be used against them in some mechanism in our society, there is going to be a very strong lobby to maintain more and more privacy. It will be a tradeoff, but I think we cannot walk away from those concerns.

Narrator: One goal of the forum was to compare the changes in the health care industry to the transformation that took place in financial services in the area of retirement planning.

Over the past two decades, the financial industry has moved from defined benefit pension plans to defined contribution 401(k) style plans.

Robert Pozen, Chairman, MFS Investment Management: I think there is huge resistance in the United States to requiring every employer, especially small employers, to offer DC plans. And I believe that that sort of political resistance will also be true in the health care area.

So what we need to think about, I believe, in both retirement and health care, is some notion of a guaranteed floor of benefits, probably through a governmental program, with supplemental and voluntary DC type plans, which allow people to get to the levels that they think are appropriate for them.

Ivan Seidenberg, Chairman and CEO, Verizon Communications: The country needs a safety net to cover those who can't afford it, that's fine. We should have whatever mandates and tax structures are available to make that happen. The only thing business wants to make sure is that it's targeted to people that need it.

Narrator: Just as in retirement planning, consumers are also being asked to take a more active role in their health care. The group discussed how the industry can help consumers take on this role by providing them with the information they need to make smart decisions.

George Loewenstein, Ph.D., Herbert A. Simon Professor of Economics and Psychology, Carnegie Mellon University: Most of the action is in improving health care behaviors. That’s where the big potential is for improving public health.

Alex Gorsky, Head of Pharma North America and CEO, Novartis Pharmaceuticals Corporation: I'd like to first thank you, Ron, and your team for bringing this very diverse, informed and certainly challenging group of people together to talk about probably one of the most important issues that we're facing as a country and a society, health care.

And we've seen in health care where in roughly the past decade has been this shift towards consumerism where we're trying to shift some of the cost and the burden of health care over to consumers.

But really the goal is with trying to have more transparency in health costs so that people understand what they're getting and what they have to pay for and to really help them make better value-driven decisions about health care.

And, while I certainly applaud those and in fact, at Novartis, we employ some of those very same plans - we think it's important for our employees. I think it's also important to have a certain caution about them.

Because if consumerism results only in short-term cost reduction, it really doesn't get to the longer term issue that I think we all have to be aware of.

We've got to look for more effective ways in helping decision making by consumers while also preserving the freedom of choice.

Narrator: While the participants expressed a wide range of opinions, they agreed on one thing: Dialogue is a healthy start to resolving the problems in the health care system and transforming it in the future.

Nancy Nielsen: We need to have a societal debate in this country about what we value. We need to acknowledge the very real problems in the health system or lack of system. We need to all acknowledge that we play a role in those problems and that we must play a part in the solution.