How Will an Overburdened System Cope in the Future?

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There's good news and bad news in this right, so we're going to expand it to 30 million people. The good news is a lot of those 30 million who don't have coverage right now or not very old the uninsured tenth will just be proportionally younger people. So that's good news that their illness profile is not as great and it's not quite a simple math if there is 300 and something million Americans and we're adding 30 million in healthcare cost is going to go by 10%.

I don't believe that if I wrote a paper with some colleague years ago when we were talking about doing this in the 90s, we actually back at the envelop math was the net increase should around 3%. And if you think about it 3% is half of what the average annual increase in expenditure in total is in any given year so it shouldn't overwhelm us it doesn't necessarily have to overwhelm us, the other point I made to people who when they say this is going to cause a shortage of doctors, and blah blah blah is look that's only presuming we keep doing things exactly the same way, so change the way we do what we do.

And I think if you look sort of innovative care delivery models, where people are confronting this challenge head on and saying, look we are going to have more people with insurance cards, what do they do when they have an insurance cards? They turn up, right? And they turn up for service.

So we've got to find a way to deliver more services by realigning and redesigning our care delivery models and I'm actually to encourage people taking on that challenge in creative ways.