18 Big Ideas to Fix Health Care Now

Our team interviewed dozens of experts dedicated to making America (and its health care system) healthier. Here, the best examples and how to make it happen.

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Photographed by Erik Butler

Steve Burd motivated his employees to practice what he preaches.

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Ken Hawkins

Yvonne Sanders-Butler stamped out obesity in her school.

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Dr. Schoenberg's new technology will allow you to see a specialist anytime without leaving home.

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Photographed by Erik Butler

Steve Burd motivated his employees to practice what he preaches.

Everyone agrees that we need cheaper, better, easier care for everyone. You know it. The guy heading to the White House knows it. Congress knows it. But knowing and doing aren't necessarily neighbors in Washington, D.C. In any case, we don't have to wait for the wonks to fix health care. Our team interviewed dozens of experts from think tanks, business, academia, nonprofits, government, hospitals, and private practice -- some of the brightest minds dedicated to making America (and its health care system) healthier. They shared their best examples of what has worked and what may work to save some of the $2 trillion we spend every year. Save big enough and we could cover the millions of people who go without coverage. Here's how to make it happen.

1. Fight the Big Five
Common chronic conditions (including coronary artery disease, diabetes, congestive heart failure, asthma, and depression) are responsible for 75 percent of our health care spending. George Halvorson, chairman and CEO of Kaiser Foundation Health Plan and author of Health Care Reform Now! A Prescription for Change, argues that we should follow the money -- and fight these diseases with all we've got, including early intervention and consistent follow-up care.

The payoff: If just 1 percent of people with these conditions were successfully treated, we could shave at least $77 billion off the health care tab. "Diabetes is the fastest-growing disease in America," he says, so focusing on that alone could save billions. "Medicare can be saved if we could cut the number of people becoming diabetic in half."

The action plan: Type 2 diabetes, in particular, is a lifestyle disease. Just a simple 30-minute walk every day, says Halvorson, could help achieve his 50 percent goal. We can all take more responsibility for our own health. Start a walking club. If you have diabetes or heart disease, follow up with your doctor and commit to a treatment plan. Learn more at fightchronicdisease.org. Need more motivation? Check out deathclock.com, suggests Rep. Jim Cooper (D-TN). It lets you see your statistical expiration date, given the risk factors of age, weight, and smoking.

2. Reduce Medical Errors by Thinking Like an Airline
Medical mistakes kill nearly 100,000 people every year, according to the Institute of Medicine. "That is equivalent to a 747 crashing every other day," says Denis Cortese, MD, president and CEO of the Mayo Clinic. These errors, more than half of them preventable, cost the United States as much as $29 billion each year.

Dr. Cortese thinks the health care system can learn from its mistakes the way the airline industry does. If a 747 crashed here, he says, the FAA would swoop in and analyze the accident, check airplanes nationwide, and do everything possible to prevent another accident. "All employees of the airline industry are expected to report near misses and mistakes within 24 hours," he says. "There is an investigation, people are thanked for making the report, and efforts are made to try to improve the services. In our health care system, when mistakes occur, we try to keep it as quiet as possible." Dr. Cortese suggests a federal health care safety reporting agency using a systems engineering approach so that medical errors can be logged, studied, and addressed -- without fear of punishment.

The payoff: A program like this could save lives and at least $17 billion a year.

The action plan: Find out more about the Mayo Clinic's health care reform efforts at mayoclinic.org/healthpolicycenter. For other efforts, visit the nonprofit National Patient Safety Foundation at npsf.org.

3. Get It Right the First Time
What a waste: As much as $312 billion is frittered away each year when patients are misdiagnosed or given the wrong treatment. Best Doctors, a health benefit offered through hundreds of insurers, health plans, and companies, is one way to help.

Founded by physicians affiliated with Harvard University School of Medicine, the Boston-based company offers its members in 30 countries customized second opinions from its network of top specialists and subspecialists around the world. For example, scans of a 12-year-old girl in Maine showed tumors in her liver and one lung, an apparent relapse from the rare form of cancer she battled as a toddler, her doctors said. But when the biopsy came back negative for malignant cancer, no one knew what to do.

The girl's father decided to try Best Doctors, a benefit offered and paid for by his employer. After top experts reviewed the girl's scans and records, they concluded the masses in her liver were a side effect from a drug she had taken years ago, while a spot on the lung was damaged tissue from her previous surgeries. The treatment? Leave the harmless masses alone. The review helped the girl avoid further biopsies and costly invasive surgeries.

The payoff: EMC Corporation, a large technology firm in Hopkinton, Massachusetts, consulted Best Doctors on 60 cases in its first year using the program. Diagnoses were changed in 15 percent of those and treatments were modified in 85 percent, resulting in $500,000 in savings.

"If everyone got the right diagnosis and treatment the first time," says Evan Falchuk, president of Best Doctors, "we could save tens of billions of dollars and an untold amount of unnecessary suffering and give millions of people the best chance to get well."

The action plan: For more information, go to bestdoctors.com or ask your employer's benefits department about a second-opinion program.

4. Pay Employees for Healthy Habits
When Safeway CEO Steve Burd discovered that 70 percent of health care costs are linked to unhealthy habits, he created incentives that sent his employees scrambling for the produce aisle. "No one quarrels with the fact that if you have three speeding tickets a year, you're a higher risk and should pay more for auto insurance," says the 58-year-old fitness buff. "Our new plan encourages employees to live healthier, and if they don't, then they bear some of the costs." Perks include lower premiums for those who lose weight or quit smoking, free or cheap gym memberships, and a $1,000 health care reimbursement check to encourage cheaper choices like generics over name-brand drugs.

The payoff: The company's new plan has saved 13 percent so far, and employees who've signed up have saved 20 to 30 percent on their premiums. If other companies followed Safeway's lead, the country could save $600 billion to $800 billion.

The action plan: Watch a video of Steve Burd at safeway.com (click on About Us), and learn more about his reform plan at coalition4healthcare.org.

5. E-Prescribe
Paper prescriptions are archaic and lead to 1.5 million injuries and 7,000 deaths each year from errors. But if every doctor got on board with an electronic Rx system, it would improve safety by making prescriptions easier to read and providing instant checks on drug interactions, dosages, and a patient's medication history. Doctors have been slow to make the expensive switchover, but now they can get free e-prescribing software through an initiative (nationalerx.com) launched by software company Allscripts. Also, physicians can now securely trade patient health and medication history through SureScripts-RxHub, the first nationwide network for e-prescriptions. Congress is providing incentives to increase Medicare payments to doctors who e-prescribe.

The payoff: This could cut drug-related injuries by a third and save $4 billion annually.

The action plan: Find out about studies, conferences, and events at ehealthinitiative.org, run by two nonprofits.

• • National Health Care
• Lose the Weight
• What Matters to Me
• • Health Insurance
• Diabetes
• • Common Problems
• • Your Tax Dollars
• Healthy Habits

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