Change. Its inarguably the word of the year. And the clamor for change can be felt at the Moscone Center in downtown San Francisco, where Americas Health Insurance Plans is holding its annual conference, ending today.
But who, exactly, should change, and how?
For the hundreds of protesters outside the conference picketing the gathering of the nation's largest health insurance group during a rare Bay Area heat wave, its the health insurance system that needs changing. More specifically, a single-payer system should usurp our current system dominated by employer-sponsored coverage, they said.
The American people are ready for healthcare for all, said Malinda Markowitz, co-president of the California Nurses Association/National Nurses Organizing Committee, which led the protest of nurses, physicians, activists and patients that flowed into the streets.
For those attending the conference (under heightened security) the answer is less clear.
Some said its the consumers of healthcarethe patientswho need to change. As in, why cant they kick their bad habits that make them obese and sick and drive up costs? Why cant they be more engaged in their healthcare choices?
Consumers, patients, whatever you want to call them, they are us, said Pamela Menard, vice president of health promotions and care management at Independent Health, a New York-based health plan. Think about us. How difficult is it to get people to change their behavior? The whole culture is, I can do whatever I want and go to my doctor and he will fix me.
Others said health plans need to be catalysts for change.
I think theres an awareness in the industry that we can be change agents, said Karen Ignagni, president and chief executive officer of AHIP. We have a very important role.
The desire to better understand the changes taking place in healthcare shows in the record 3,200 participants at this years conference, up from about 3,100 last year, she said.
This years institute, as the conference is called, is focused on hot topics for change: wellness and prevention, consumerism, quality and health information technology.
The topic of consumerism attracted a lot of interest.
In truth, consumers are hungry for change in healthcare, according to a survey of 3,000 people presented to a packed audience by the Deloitte Center for Health Solutions.
Some 65% of consumers are interested in personalized tools that will help them improve their health. And 73% are interested in accessing data on price and quality of healthcare from their health plans, according to the survey.
We were a bit surprised that a large number of consumers were responsive to innovations, said Paul Keckley, executive director of the Deloitte Center for Health Solutions. However, Keckley cautioned that the U.S. healthcare system is not easy to change. The Scud missile that flies into that is the employer, he said.
Rising premiums are driving change because they are hitting employers where it hurts: their bottom line, attendees said.
The prospects for healthcare changes from Washington are good. Or poor, depending on whom you ask.
Former HHS Secretary Tommy Thompson declared 2009 the year for healthcare policy change. The stars are aligned, he said.
Former Republican Senate Majority Leader Bill Frist disagreed, saying he was not optimistic we will see reform because energy costs, the economy and the war will dominate the agenda next year.
Meanwhile, former Democratic Sen. John Breaux of Louisiana said change would only happen through public-private partnerships, pointing to Medicare Part D as a shining example.
In a rare moment of bipartisan agreement, both Dan Bartlett, former counselor to President Bush, and Terry McAuliffe, chairman of Hillary Rodham Clintons presidential campaign, said healthcare reform would be a priority for the new president in 2009.
You want to do it quickly when theres enthusiasm and excitement with a new administration, McAuliffe said.
Bartlett asked another familiar question. Can new constituencies be formed in Washington for it to happen?
The answer is partly up to the health plans, who at least are thinking hard about the issue. According to Bruce Henderson of PricewaterhouseCoopers, a closed seminar to health plan CEOs at the AHIP conference was expected to have 30 executives in attendance. Instead, about 80 health plan executives packed the room to talk about innovations. The C-suite is very engaged, Henderson said. They are excited about being part of change.
Rebecca Vesely, based in San Francisco, covers the health insurance industry.