Anticipating the Future of Healthcare Regulation Les Wallace, Ph.D. Welcome the New Normal: Permanent Whitewater. 2009 BOC Athletic Trainer Regulatory Conference. Remember the 1990s…. 401Ks… Unemployment 4% Prozac… Tina Turner Retires… Christian Science Monitor…
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Les Wallace, Ph.D.
Welcome the New Normal:Permanent Whitewater
2009 BOC Athletic Trainer Regulatory Conference
“The future ain’t what it used to be.”
War and Terrorism
ongoing smoldering in
Middle-East, Indonesia, Africa,
“Caught between the Dow and the Tao.”
Google “healthcare reform” and “healthcare regulation” you’ll get 87 screens for each--averaging 9 entries each screen.
…“healthcare professional licensing” and get 91 screens averaging 9 entries each.
…“State healthcare regulation:” 85 screens averaging 9 entries each.
“Refresh”—eases brain fatigue & enhances alertness
“Recall”—provides total recall and photographic memory
The Extreme Future
SERMO Medical Social Networking
…55,000 Physicians convening peer to peer knowledge around their cases, test results, and treatment plans through Net 2.0 models
eICU: a Physician manages up to 120 patients from a distance in 5 different ICUs [20-30% reduction in mortality and complication rates]
UltraClinic: same day interpretation of breast-biopsy tissue and technical consultation using advanced optics converted to video monitor. (U. AZ)
WalMart Clinics: 30 (3,289 domestic stores)
Myca / “Hello Health”—a face book-like physician storefront: twitter and paypal patient interaction
Kaiser tested IT interfaces to reduce patient visits to Drs. and found a 25% reduction impact
Remote Sensing…“OnStar™” for healthcare:
EKG, Temp., Blood O2, motion orientation
Remote sensing in the works:
eNose, Blood Count/Chemistry, Internal Organ Viewing
“Weekly Address: Health Care Reform as the Key to Our Fiscal Future”
“White House: Health care
Reform will pass this summer”
“Obama Signals Flexibility on Health Overhaul”
Universal coverage options (+/- 46 million people)
Prevention and public health (currently .04 cents per $)
HealthCare or SickCare Plan?
Incentives for excellence / quality
Competition in the insurance industry (2 companies dominate 1/3 of all healthcare insurance)
Tax credits / Taxable Benefits???
Pharmaceutical Cost Management
Efficiency through Electronic Medical Records
Medical malpractice reform
Medicare waste and fraud crack down
“Comprehensive health reform by the end of the year!”
“Reform that slowed annual rate of health costs by 1.5% would boost economic output by over 2% and increase household income by $2,600 in 2020.” President’s Council of Economic Advisors
72% of Americans favor expanding the
Federal Government’s role in the healthcare system.
Just possibly we’ve reached a reform tipping point
“One of the most cost effective means of expanding health insurance.” MIT Economist James Gruber
…in 2008 projected to cost nearly 40% less than originally estimated.
…87% of participating seniors are satisfied with their coverage
?Exact model of “universal coverage”
?How “national standards” for health insurance and federal authority might impact a tradition of state authority
?What changes in reimbursement will mean to Non-MD providers
?How health professional regulators will get squeezed—more work, less resources, more complexity, greater transparency
85% want major healthcare reform
72% favor a gov’t. administered health plan like Medicare that would compete with private plans.
57% are willing to pay higher taxes to make it so.
86% felt rising costs posed a serious economic threat
65% believe providing for uninsured more important than “keeping costs down.”
“2009: do you think the government would do a better or worse job than private insurance companies?”
50% better34% worse
30% (2007)44% (2007)
“The future ain’t what it used to be.”
So let’s go with what we know:
76 million baby boomers retire in the next 20 years…
…and bring with them some of the most expensive healthcare demands of a generation.
“Walkers may likely outnumber strollers in the U.S.”
NEWS FLASH: As of today…1/3 of retirees are re-entering the workforce for Encore careers.
[see “The One Slide Project”]
-.05% 1984 -1.5% ‘89-’99 -2.2% 2004-08
UCLA $93,000Mayo Clinic $53,432
[Dartmouth University Study 2009]
You’re in Luck if your profession…
Can you say HR 1137—Athletic Trainers Equal Access to Medicare?
Financial Planning: CFPRCFAR CFS ChFC CIC CLU CIMA CMT CPA PFS
Business and Executive Coaching Credentials:
Personal Training / Fitness:
American College of Sports Medicine (4)
American Council on Exercise (4)
American Chiropractic Board of Sports Physicians (2)
The Cooper Institute (1)
International Fitness Professionals Association (1)
National Academy of Sports Medicine (1)
National Council on Strength and Fitness (1)
National Exercise and Sports Trainers Association (1)
National Exercise Trainers Association (1)
National Federation of Professional Trainers (1)
National Strength and Conditioning Assoc. Cert. Comm. (2)
e.g. NOCA 1100 – Quality Standard for Assessment-Based Certificate Programs (2009)
Government has a basic responsibility to ensure that health plans and providers are qualified and operate in the public interest.
Now there’s an easy regulatory job.
Without which we have bridges that collapse, Ponzi financial scams, quacks practicing medicine, dangerous pharmaceuticals, failed banks, and bankrupt insurance companies
“The Politics of regulation are challenged by the need to be socially responsive and challenged again by needing to be “coherent” with the underlying legal system.
Guenther Teubner, Professor Law, University of Frankfurt and London School of Economics.
increasing mutual need for this dialogue.
Promoting continuing competence and regulatory oversight of competence… pressured by all of these forces:
Legislators—Stifle a Laugh
Media—Stifle a Laugh
Health care regulation is still the most mature, most advanced, most competent, and most complex of any regulatory responsibility.
It makes oversight of the banking industry look like child’s play.
You’re fortunate leaders…
A Visionary Board and Staff have convened you to touch the future.
Let the dialogue begin!
Patricia Aburdene, Megatrends 2020 (2005)
James Canton, The Extreme Future (2006)
Robert Field, Health Care Regulation in America (2007)
Thomas Friedman, The World is Flat (2005)
Mark Penn, Microtrends (2007)
J.L. Petersen, Out of the Blue: Wild Cards and Other Big Future Surprises (1997)
Peter Schwartz, Inevitable Surprises (2003)
Edie Weiner and Arnold Brown, Future Think (2006)
Daniel Yankelovitch, The Magic of Dialogue (2006)
Y. Wind & C. Crook, The Power of Impossible Thinking (2005)