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Speeches matching topic Health Care Policy and speakers whose last name begins with G
Showing 1 - 6 of 6 speeches.
Rudy Giuliani (Exclusively WSB)

Even though health-care reform passed through Congress and has been signed into law, a public policy debate still rages on as to whether this is the right piece of legislation to fix century-old issues. As mayor of one of America’s largest cities,Rudy Giuliani developed a comprehensive model to promote enrollment in public health programs. As a presidential candidate, he advocated development of a national tax-free health savings account. And, at Giuliani Partners, companies have sought his expertise to tackle a range of health-care projects including the need to combat the national epidemic of prescription drug abuse. A solution to the crisis will require the combined efforts of the health-care community and federal and state officials. With a strong viewpoint and years of experience on the issue, Giuliani shares with audiences:

  • His views on the Affordable Care Act
  • Insight on how seemingly insurmountable challenges, such as health care, can be overcome with effective leadership
  • An overview of the steps the health-care community and the nation’s elected representatives must take to help alleviate our health-care challenges

The expansion of health insurance for the uninsured and more generous insurance for the already insured will cause a huge increase in demand for care, especially primary care, and no increase in supply. The waiting lines will grow at the doctor’s office, at the emergency room and everywhere else. Those who can afford it will turn to concierge doctors, to avoid rationing by waiting. But this will make the problem worse for everyone else. Anyone in a plan that pays below market will be pushed to the rear of the waiting lines.

At the same time, the need to control costs will bring about another form of rationing. There will be enormous pressure to deny patients treatments until they have been proved to be effective. Since most of what doctors do today is not “evidence based,” patients may be denied access to therapies that they currently take for granted.

Here is what must be changed: (1) a mandate to buy something whose cost will grow at twice the rate of growth of our incomes, (2) a bizarre subsidy system that will force a complete restructuring of American industry, (3) a health insurance exchange in which insurers will have perverse incentives to over-provide to the healthy and under-provide to the sick, (4) an exchange in which individuals will have an incentive to wait until they are sick to purchase coverage, get their medical bills paid, and then drop coverage again, (5) a tattered social safety net, with greater demands for subsidized care and less money to meet those demands, and (6) impossible spending cuts for the elderly.

Here is what needed change will look like: A workable system of subsides for private insurance and a health insurance marketplace in which insurers are encourage to compete to take care of the sick, as well as the healthy.

In 2012, the federal government will require one out of every 10 dollars of general income tax revenues to keep its promises to seniors under Social Security and Medicare. That means to balance the budget, the federal government will have to stop doing one in every 10 other things it has been doing.

By 2020, the federal government will have to stop doing one in every four things it has been doing, if seniors are to get all their promised benefits. By 2030, about the midpoint of the baby boomer retirement years, the federal government will have to stop doing almost one in every two things it does today. There is only one way out of this crisis: move to a funded retirement system in which each generation saves and invests and pays its own way.

There is only one reliable way to reduce costs, increase quality and improve access to care: rely on the power of competitive markets. That means giving patients control over health care dollars and allowing providers to compete on price, quality and the convenience of care. Where ever third-party payers are not dominant, we see the power of this approach: cosmetic surgery, Lazik surgery, walk-in clinics, mail order drug houses, telephone and email consulting services, concierge doctors, international medical tourism and in the emerging market for domestic medical tourism. Where the greatest opportunity exists: chronic illness.

Health care is a complex system. The key components of complex systems cannot be copied, duplicated or replicated. Most important of all, they cannot be managed from the top, down. Almost everything we are doing to control costs, boost quality and improve access treats health care as an engineering problem—one that can be fixed following a book of rules.

In fact, complex systems rarely ever work unless people are liberated. That means eliminating perverse incentives and freeing the doctor, the patient, the employer, the employee and everyone else in the system—giving them the maximum opportunity to solve each other’s problems.

Showing 1 - 6 of 6 speeches.
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