News release: National

April 29, 2003

For more information, call:
David O'Grady
Kaiser Permanente
Phone: (510) 271-4674
E-mail: David.O'Grady@kp.org

Leading health industry experts offer seven-step solution for safer, better, and more accountable health care

Authors George C. Halvorson of Kaiser Permanente and George J. Isham, MD, of HealthPartners examine the impending health care crisis—and provide a way to solve

Washington, DC – Americans receive some of the best medical care in the world, but the "miracles of modern medicine" often are applied inconsistently, unsafely, and at a price tag that is putting those miracles out of reach for many purchasers and patients. Understanding the dynamics of health care and how we solve the current health care crisis are the subjects of the new book, Epidemic of Care: A Call for Safer, Better, and More Accountable Health Care.

The authors, George C. Halvorson, chairman and chief executive officer of Kaiser Foundation Health Plan and Hospitals, and George J. Isham, MD, medical director and chief health officer of HealthPartners, represent two of the nation's leading and most esteemed nonprofit health care organizations. Halvorson and Dr. Isham draw upon their 50 years of combined leadership experience in health care to examine in plain speech why health care costs so much, and why the results are so inconsistent.

Delving deeper into the issues surfaced by a landmark Institute of Medicine report—which revealed that between 44,000 and 98,000 Americans die each year in hospital accidents—the authors discuss a number of insightful findings from recent health care journals and reports. Most importantly, the authors take a hard look at what Americans are really buying for their health care dollars:

Fewer than 10 percent of patients with congestive heart failure receive the care they need. The remaining 90 percent are significantly more likely to suffer unnecessarily and die too soon because they didn't receive best care.
Fewer than half of all doctors provide full and appropriate follow-up care to people with diabetes. Kidney dialysis units are full of patients with failing kidneys who would not be there if they had received best care.
Health care costs could be reduced by 20 percent for diabetes if doctors delivered the best-care treatments for diabetes and were supported by systems and teams.

"We can solve the problems of skyrocketing costs and uncertain quality," Halvorson said. "But no one can solve it alone. We must make the crisis in health care a national priority and implement solutions that reflect the needs of many constituencies, especially the health care consumer."

"As a physician and leader, I see firsthand the inconsistencies that plague health care and the missed opportunities to make health care better," Dr. Isham said. "As an author, I have the opportunity to address the problem of health care from a point of view that gets beyond political debate to real solutions for real patients."

With that in mind, the authors of Epidemic of Care provide practical and field-tested suggestions about how to make health care more accountable, efficient, valuable and accessible. The solution outlined by Halvorson and Dr. Isham requires a marketplace-driven, national health care strategy addressing seven key priorities:

Systematically improve health care quality and patient safety.
Health care quality must be measured by health outcomes against well-defined best-care practices. Doctors must take the lead in developing and sharing best-care practices, with support from health care organizations and professional and disease associations. New technology, such as the Internet and the automated medical record, also can help doctors keep up to date without getting buried in an avalanche of studies and medical journals.
Create an improved market model for the buying and selling of health care that is sensitive to consumer needs, behaviors and incentives.
Quality health care information must be applicable and usable for purchasers and patients. This includes communicating measurable health outcomes and processes, and providing information on protocols and best-care standards to patients. In this way, purchasers and patients can make informed decisions that influence how health care is delivered.
Improve population health.
Medical Savings Accounts and similar so-called "consumer" products do not foster improved health or reduce costs. Instead, by focusing on the major diseases and chronic illnesses affecting the most people, health care can improve quality outcomes and reduce unnecessary costs.
Prevent care monopolies and other anti-competitive practices.
Only a competitive marketplace can continue to push the envelope on quality health care, develop future medical miracles, offer consumers a range of choices, and avoid bureaucratic administration.
Create a framework for delivering health care services to the uninsured.
Insured Americans ultimately pay for the uninsured. But the number of uninsured could be cut in half by developing programs for each category of uninsured, especially the working uninsured.
Invest heavily in training and education, research, and re-engineering of health care delivery to continue development of medical miracles.
The shortage in health care workers can be resolved with improved training and recruiting, a re-engineering of the many cumbersome or broken work processes found in health care, and a focus on preventing chronic illnesses that consume significant health care resources.
Implement automated medical records in order to reduce medical errors, improve quality outcomes, and deliver real-time information and support to health care professionals.
Providing automated medical records to physicians and other health care professionals will streamline the handling of patients' medical records and help reduce errors and inefficiency. Automated medical records also will enable Internet interactions with patients and among physicians, improving the exchange of information in real time, giving patients more flexibility, and ensuring confidential access. Kaiser Permanente is investing $1.8 billion in a new automated medical record system to transform the way it cares for its 8.4 million members.

"There is no single villain responsible for our troubles and no silver bullet to cure them," said Stanford University's Alain Enthoven, Mariner S. Eccles Professor of Public and Private Management (Emeritus), Graduate School of Business, in the book's foreword. "Halvorson and Dr. Isham have personally led many of the innovations they describe, and their recommendations are well grounded in experience. They know what they're talking about."

Halvorson is the chairman and CEO for Kaiser Foundation Health Plan and Hospitals, known by its service mark Kaiser Permanente. He has been the CEO of several health plans, with his longest tenure as president and CEO of HealthPartners in Minnesota. Author of several books, his most recent health care-related book is titled Strong Medicine. He currently serves on the Commonwealth Fund Task Force on the Uninsured and is a member of the Harvard Kennedy School Healthcare Delivery Policy Program Advisory Committee.

Dr. Isham is medical director and chief health officer for HealthPartners, a consumer-governed health care organization in Minnesota. He is responsible for health promotion and disease prevention, research, and health professionals' education at HealthPartners. Isham is a founding board member of the Institute for Clinical Systems Improvement. He has served on the Institute of Medicine's (IOM) Board on Health Promotion and Disease Prevention and has chaired the IOM's recent report, Priority Areas for National Action: Transforming Health Care Quality.