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Six Predictions for Healthcare Strategy in 2010

Philip Betbeze, for HealthLeaders Media, December 18, 2009

Will Tiger Woods come back to golf? Will his wife come back to him? Is Michael Jackson still alive and in seclusion? Will Elvis pick 2010 to reveal where he's been hiding for 33 years?

Yes, it's that time of the year again. The tabloids are making predictions for the year ahead, and it isn't only the trash journalists who are doing it. Mainstream media is making predictions about what lies ahead in sports, politics, and business for 2010.

As healthcare strategy journalists, we're not immune from inundation of press releases about what's likely to come in 2010. So I'm getting into the game too. Here's a look into what my crystal ball is telling me for next year about healthcare business strategy, and yes, I'll revisit these picks in one year to find out how well I did.

1. Meaningful healthcare cost reform will elude the scalpel.

It's too difficult politically to pass anything on health reform that will truly move the needle on cost control in healthcare. What has been touted as an overhaul that is transformational rather than incremental has died a death from a thousand cuts since its unveiling early last year. That's because our Congressional leaders have again proven how beholden they are to special interests, whether they represent drug companies, device makers, physicians or hospitals. Any time a proposal surfaced that would have drastically cut the flow on the money hose from which any of these groups are drinking, it was soon exposed as lacking the necessary political support to move through the Congress.

2. Coverage will increase, but to what level?

This will be the one area on which Congress will be able to say they've achieved their healthcare reform goals. One, it's politically popular to increase coverage for the uninsured among the democratic base. Two, it's the path of least resistance. Despite the fact that the United States is more than $1 trillion in debt, other countries still lend to us. That means truly tough choices on what to do on the government front will remain regulatory and incremental. Members of Congress don't have to apologize—at least until much later—for adding an unaffordable entitlement. All the interest groups win to some degree, while only future generations must foot the bill. Bravo, Congress. One day, however the piper will have to be paid. Just not now.

3. Employers will largely abdicate their push for value.

For a long time, employers have been pushing providers and health plans to justify their huge annual premium increases that have well outpaced inflation. They were right to push for transparency and quality improvement, and have had limited success in these areas. But with coverage extended to the uninsured, the pressure's off. They're already making workers bear much more of the costs of healthcare, and in the long run, that's a good thing, but the sense of urgency with which employers have been pressuring providers and health plans will have lifted. Perhaps where employers failed, consumers can make a difference? Perhaps. Consumer shopping for the best prices is the cornerstone of our economy, but it remains to be seen whether this force has met its match in healthcare.

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