What Is Your Vision for Healthcare Reform?

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You have to pay people where they make money by keeping people healthy, figuring out how to keep people healthy. I often say that prevention is going to be the key to a higher quality system at lower cost and by prevention people think, all well it's vaccines, it's a cancer screening test like colonoscopy, mammograms or pap smear, but I actually mean what's called tertiary prevention.

That's prevention of people who already have establish chronic illness. Because people with chronic illness, the 10% of American population who have real serious chronic illness or multiple chronic illnesses, they're the people who use the healthcare system. They account for two thirds of all the spending.

So if you really want to improve the quality of the system and reduce the cost, you have to focus on these people with chronic illness. Whether it's heart disease, congestive heart failure, emphysema diabetes, hypertension, asthma, cancer, that's your population to focus on. It is 10%, so we have a very it's relatively limited and you have the, what the system needs to do is focus on them and figure out alright how to we prevent them from having say an exacerbation of emphysema that lands them in the hospital and then we discharge them and then they come right back because they've got pneumonia or they have had another exacerbation.

When we incentivize caring for the whole patient, keeping them out of the hospital, then we'll see doctors really work at it well, what are the combinations interventions that will allow me to keep them healthy, functional and away from doctors because if they're not using services, I will actually make more money that is going to be a very I think new day in America, that's some, we really will have a health care system.