Utah's former governor and the nation's top policymaker on health care said consumers need better information on medical costs and quality before the "system" can be considered just that.
"Right now, it's a sector. There's nothing systematic about it," said Mike Leavitt, secretary of Health and Human Services.
Leavitt spoke to reporters Thursday at the University of Utah's Hinckley Institute of Politics. Later, he met with members of the Utah Partnership for Value-Driven Care, a coalition just designated by the national agency as a "Chartered Value Exchange." That's a distinction given to health-reform partnerships that are taking active steps to improve health care and connect consumers to it. Fourteen collaborations in a dozen states have been so designated, with more to come.
The Utah partnership, headed by HealthInsight, involves a diverse group of community leaders from business, the insurance industry, health care providers and the public, as well as public officials. The goal is a health care system overhaul.
With the designation, Utah's coalition will soon have access to Medicare performance measures that look at the quality of care a doctor delivers to patients. It can use that data, along with private-sector data, to create tools for consumers so they make good choices about where and how and what kind of health care to get.
Leavitt said the agency's vision of health care reform requires more and better use of technology. Patients and providers alike need to be able to access health records electronically.
Other key points include the need for patients to have access to quality and cost information to help them make better choices. An insurance company might, for instance, pay a higher percentage of the cost when a patient chooses a surgeon with a good success rate who provides care at a reasonable cost.
His department's health reform efforts, Leavitt emphasized, are not about creating a government-run health care system.
"The people have always rejected the notion that government ought to run" health care. Still, he added, there may be a role for government.
Reform, though, is not a simple process, he said. Tax codes have to be changed so that people who buy their own insurance aren't treated differently tax-wise than those who get it through their employer. Eighty-five percent of medical records are on paper still. There's not yet enough meaningful collaboration nationwide. Those are big barriers.
But he said he's optimistic. "I think we've made progress on both cost and access," he said. "States all over the country are trying."The federal government is taking several approaches to speeding the integration of information technology into health care. For example, Medicare is going to pay about 1,200 physicians nationwide at a higher rate for using electronic records instead of paper.