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Tech, Insurance Changes Ahead In Health Care

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SOUTHFIELD (WWJ) - The nation’s health care delivery system is about to change dramatically, and federal health care reform is only part of the reason.

An expert panel scratched the surface of the big changes ahead in a fascinating hour-long discussion Thursday at Lawrence Technological University in Southfield, sponsored by Lawrence Tech, WWJ Newsradio 950 and the Great Lakes Innovation and Technology Report.

Patrick McGuire, senior vice president and CFO of St. John Providence Health System, predicted that in the next five years, there will be more change in health care than any point since the introduction of Medicare nearly 50 years ago.

A key driver to this change, he said, is the Affordable Care Act. Even under a Republican president, and even if the Supreme Court strikes down the act’s mandate that individuals buy health insurance, McGuire said the “basic building blocks of the act are here to stay, because the basic drivers of the Affordable Care Act were already in motion because of unsustainable cost increases.”

Hundreds of thousands of people in Michigan alone will be newly eligible for Medicaid under the act, and state health insurance exchanges will offer up more choices. All this is happening, he said, against a backdrop of an aging Baby Boomer population and growing concern about the size of the federal debt. McGuire noted that the last president to balance a federal budget, Bill Clinton, “did it by raising taxes and cutting Medicare.”

Mary Ann Tournoux, senior vice president and chief marketing officer of the Detroit-based Health Alliance Plan of Michigan, said her insurer is moving toward “value-based insurance design,” under which individuals working for the same employer may have markedly different coverages depending on their chronic conditions and behaviors.

“We’ll be asking consumers to pursue healthier lifestyles and to follow the treatment programs of their doctors,” she said.

And there will be incentives and disincentives to get them to do so — for example, cheaper insulin for diabetics to keep them out of expensive hospitalizations, and higher charges for medical tests that scientific evidence shows aren’t necessary.

Dr. Betty Chu, an obstetrician and gynecologist at Beaumont Troy Hospital, said patients today feel more healthy if they ask their doctor to run more tests — but what’s really important to keep people healthy is better service and communication.

Chu, who also sits on the boards of Beaumont Health System and the Michigan State Medical Society, said popular media also play a role in patient behavior.

Panelists said people will be creating businesses to help them navigate the health care system, either on their own behalf or someone else’s, like an ailing parent.

And they said high tech will have an ever more prominent role as doctors, laboratories and hospitals struggle to digitize and share the huge volume of patient information. Chu said she thinks most people will wind up carrying a card with their complete medical history, security concerns aside — after all, they now carry their entire bank account in their pocket, protected only by a four-digit number.

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