January 9, 2017 (SAN FRANCISCO, CA) – In an era of unprecedented national polarization, why would anyone want to highlight disagreement? One new initiative has an answer: use constructive expert debate to help the public better understand opposing views on controversial topics – in this case, US healthcare. Launching today, The Zetema Project has assembled an unusually diverse group of healthcare leaders that includes officials from both Democratic and Republican administrations and Capitol Hill, as well as senior executives from health systems, insurers, pharma, organized medicine, and patient advocacy groups.
Among the panelists are Dr. Mark McClellan, former Bush Administration FDA Commission and CMS Administrator; Dr. Ezekiel Emanuel, former special advisory on health policy to President Obama; Drew Altman, President and CEO, Henry J. Kaiser Family Foundation; Dr. David Blumenthal, President, The Commonwealth Fund; Dr. James Madara, CEO/EVP of the American Medical Association; Karen Ignagni, President/CEO of EmblemHealth and former President/CEO of America’s Health Insurance Plans (AHIP); Jack Bailey, President, US Pharmaceuticals, GlaxoSmithKline; and Dr. Penny Wheeler, President/CEO, Allina Health. They are joined by other household names in health policy. The entire panel can be seen here.
Founded by healthcare entrepreneur and philanthropist Mark Zitter, the group will gather on January 17, just three days prior to the Inauguration of President-Elect Trump, to exchange views about the problems in US healthcare and their possible solutions. With a focus on the roles of government and private companies, and markets and regulation, “Issues related to repealing and replacing the Affordable Care Act will be high on the agenda,” says Zitter. However, he points out, “Unlike other groups, the goal is not to reach consensus, but to illustrate the pros and cons of various policy options.” Conversations about contentious healthcare issues are available on the Zetema Project’s website in a debate format so visitors can evaluate the arguments for themselves. The public can join the debates through comments and surveys on the site, zetemaproject.org.
As a first step in exploring the panelists’ priorities and differences, The Zetema Project challenged each panelist to provide a single recommendation for the incoming Trump Administration. Initial responses, posted on the Project’s website, reflect ideas as diverse as the panelists themselves.
Several panelists made recommendations directly related to repeal and replace. Emanuel, a key architect of the Affordable Care Act (ACA) who has been consulted by the Trump team, warned “Maintain Stability in the Exchanges to Avoid Chaos.” The head of the nation’s largest state-based exchange, Peter Lee of Covered California, detailed the successes his exchange has had and suggested “Apply Real-World Lessons to Health Reform.” Another former Obama advisor, Venrock partner Dr. Bob Kocher, wrote “Focus on Lowering Premiums – Not Re-Litigating the ACA.” And Allina’s Wheeler implored the incoming Administration to avoid upending the current system with “It Was Broken! Please Don’t Stop Us From Fixing It!”
Other panelists focused on the delivery system, especially the substantial problem of wasteful healthcare spending. Walmart’s Senior Vice President for Global Benefits, Sally Welborn, wrote “Eliminate the Care That Doesn’t Help Patients.” Noted healthcare improvement leader, Dr. Brent James of Intermountain Health Care, suggested “Look Beyond Coverage Expansion to Improve Healthcare.” Leading patient advocate Debra Ness of the National Partnership for Women and Families encouraged the new Administration to “Make Value the Priority.” American Nurses Association President Pamela Cipriano was quite specific: “Link Payments to Quality – Sound the Death Knell for Fee-for-Service Medicine.”
Many panelists offered patient-focused recommendations, albeit from different angles. Molina Healthcare CEO Dr. Mario Molina suggested “Focus on the Patients, Not the Politics.” The AMA’s Madara made a similar point from the physician’s standpoint with “Allow Physicians to Refocus on Patient Care.” Vocera chief medical officer Dr. Bridget Duffy, the nation’s first chief experience officer, posed the intriguing idea of appointing such a leader for the nation: “Create a Chief Experience Officer (CXO) for the US.” Kaiser Family Foundation’s Altman encouraged the President-elect to combat rising out-of-pocket costs in “Prioritize the Consumer Agenda in Healthcare.”
In response to the nation’s political polarization, there were calls for better communication and collaboration. Lilly USA president and former Medicare official (under George W. Bush) Alex Azar recommended “Listen to Healthcare Leaders, Strengthen What Works.” Former Medicare chief (under George H.W. Bush) Gail Wilensky encouraged the President-elect to “Build Consensus to Replace the ACA While Maintaining Coverage.” And GlaxoSmithKline’s Bailey contributed “Collaborate to Build a Successful Market-Based System that Works for Patients.”
Not every blog post dealt directly with the healthcare delivery and financing system. Panelists also were concerned with medical innovation and technology. Dr. Elizabeth Nabel, President of Brigham and Women’s Healthcare and the former Director of the National Heart, Lung & Blood Institute, requested that the new Administration “Maintain NIH Funding to Enable Life-Changing Medical Breakthroughs.”
The Zetema Project will continue publishing its series of blogs and debates on key healthcare policy questions following this month’s meeting, with particular focus on the options lawmakers discuss for healthcare reform.