The U.S. healthcare system doesn't incentivize people to stay healthy or help them shop for competitive prices and higher quality care or obtain needed follow-up care, said Aetna Chairman, President and CEO Mark Bertolini
in Monday morning's opening keynote speech at the Healthcare Information and Management Systems Society Convention & Exhibition
Likening the nearly 70-year-old configuration of the U.S. healthcare system to a rats' maze, Bertolini said, the system has physicians, hospitals and insurance companies each erecting barriers to navigation and the free flow of patient information.
“What we've done with the Affordable Care Act
, we've put 2 to 4 million people into the rat maze,” he said. Without changing it, “All they're going to do is spend more money.”
As a result of the disconnections and barriers, 30% of U.S. healthcare spending is wasted, he said, citing figures from a 2009 Institute of Medicine
report. Meanwhile, 171 million Americans suffer from chronic conditions that consume disproportionate healthcare resources. Healthcare has soared to 17.9% of GDP.
Most importantly, health insurance premiums have been growing at four times the rate of inflation, he said. “Consumers are paying 50% of the increases in costs in premium increases and benefit changes.” Soon, they will be paying more than half of all healthcare spending.
“This issue is here today and we need to solve it today,” Bertolini said. The growth in healthcare spending, “can't keep continuing to increase. We can't afford it.”
Bertolini's company has made some major technology investments, including the acquisitions of health information exchange services provider Medicity and consumer facing mobile app iTriage and its developer, Healthagen, all in 2011.
Bertolini offered three prescriptions for change: payment reform; improving care for the chronically ill; and “we have to start investing in wellness,” he said. “We need to empower our customers to take control of their healthcare through digitally empowered tools.”