If you look at the congressional agenda, you may think the two most significant issues facing healthcare in 1999 are reforming Medicare and patients' rights.
But if you listened to eight industry experts at a forum on challenges facing healthcare in the next millennium in St. Louis earlier this month, you'd have heard a lot less about those issues and a lot more about the need to address the growing number of uninsured Americans.
John Dubinsky, chairman of the board of St. Louis-based BJC Health System, set the tone for the event when asked to describe the most critical issues in healthcare today: "How do we include the 40 million uninsured Americans in the healthcare system?" he asked. "It is unacceptable that this population does not have access to the wonderful U.S. healthcare system."
Dubinsky spoke to about 250 invited guests on the campus of BJC-affiliated Washington University Medical School in St. Louis. The program was sponsored by the American Association of Health Plans and MODERN HEALTHCARE, and Dubinksy was a member of a distinguished panel convened to peer into the future.
"Health 2000: Challenges of the Next Millennium" was conceived to bring national experts together with local providers to discuss the country's most pressing healthcare needs. The session on Feb. 10 was the first in a series of five. The others will take place on March 3 in Seattle, April 15 in Dallas and May 5 in Miami. A capstone event will be held in Philadelphia at a later date, to be announced.
Donald Young, M.D., senior vice president for policy and clinical services at the AAHP, noted that access is linked to affordability of care. For every 1% increase in employer premiums, about 600,000 people lose their insurance coverage.
Increasingly, the uninsured are not the poor but workers who are offered insurance and decline it, Young said. "It's working its way into the middle class. Employers don't want to fiddle with benefits in a full employment economy," but when the next economic downturn hits, employers will use the opportunity to trim insurance or dump that responsibility on their employees. Healthcare providers had better be ready when that happens, he said.