Insurance reform and payment reform are not enough to curb the unsustainable growth of medical costs in the U.S., Delos "Toby" Cosgrove, chief executive and president of the Cleveland Clinic, said at The First Draft of History, a conference in Washington, D.C. produced by The Atlantic, the Newseum and The Aspen Institute. It is essential, he said to also implement changes to the delivery of care, as well as to decrease the burden of disease in the United States.
Current health care legislation "is about insurance reform and payment reform," Cosgrove said. "It is not health care reform."
The number of elderly people in the U.S. is increasing, while the number of sophisticated treatments available increases as well -- both bringing costs up.
"Add to that the situation where we maybe bring another 40 million people under coverage, you're going to see a continuing escalation of health care we're not going to be able to sustain at the present time," Cosgrove said. "We've got to figure out a way to do it more efficiently -- that's going to require doctors to be integrated with hospitals, and hospitals to be integrated with hospitals."
At the Cleveland Clinic -- one of the top medical facilities in the U.S. and one of the largest private medical centers in the world -- the physician-based surgery and medicine departments are integrated into collaborative teams.
Cosgrove said he suspects Congress may pass a health care bill this year that addresses payment and insurance reforms and may return to health care delivery reform with a second bill.
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The nation also needs to address preventive care and wellness, he said. Smoking, inactivity and disease lead to 40 percent of the premature deaths in the United States, he said. They also lead to chronic disease, which accounts for more than 70 percent of health care costs.
"We're not going to be able to afford the sort of care we'd like to see... if we don't control this tsunami of obesity," Cosgrove said.
The Cleveland Clinic says it has instituted its own wellness programs to curb smoking and obesity with remarkable results. Cosgrove said the clinic does not allow smoking on its campus, does not hire smokers and that soda, candy and food with trans fats were taken out of the hospital cafeteria. The clinic offers its employees free Weight Watchers programs and free access to its gym, among other things. In the past nine months, the clinic has collectively lost 112,000 pounds.
More from the "First Draft of History" Conference:
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Geithner: Goal is not to Save People From Mistakes
Petraeus: Afghanistan is not Iraq or Vietnam
McCain Pushes for More Troops for Afghanistan