For the week of August 6 - 12, 2003

National health care speakers present future to SV philanthropy

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"The future will not be shaped by the majority. As a collective we are often dumber than we are as individuals ... the power of a community is to challenge the prevailing way of thinking."

— LEANNE KAISER CARLSON, health care consultant

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"I hope someday we will find a way for everyone to have access to (universal health care) ... Whatever we do it will be messy."

— DR. GAIL R. WILENSKY, former Medicare director

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By MATT FURBER
Express Staff Writer

Valley health care providers, supporters and donors were treated to a healthy dose of wisdom and experience about the future of health care in a discussion Friday, Aug. 1, in the Limelight Room at Sun Valley Resort.

St. Luke’s Wood River Foundation organized the event to share their appreciation for local philanthropists, who, through half a decade of giving, made St. Luke’s Wood River Medical Center possible.

The evening was underwritten by GE Medical Systems, said Foundation President Shirley Renick.

Guests were treated to two national speakers who addressed distinct aspects of health care. Led by hospital Chief of Staff Dr. Herbert Alexander, a "game show" panel of St. Luke’s staff physicians concluded the evening by discussing, as the emcee himself Alexander put it, "What’s New and What’s True" at St. Luke’s.

Dr. Martin Durtschi said the two biggest challenges at St. Luke’s were having enough volume for doctors to keep their skills in shape and making sure doctors have the support they need.

Washington, D.C.-based political insider Dr. Gail Wilensky, who was the director of Medicare under former President George H. W. Bush, gave her perspective on the health care subsidies and the troubles with managed care.

"For the last 20 years Medicare has moved in exactly the wrong direction ... as good as it is it looks a lot like a 1960s program," Wilensky said. "There is no catastrophic coverage or outpatient care. We can do it smarter. We need better information about what works."

Colorado based futurist and health care consultant Leanne Kaiser Carlson led off the evening with stories about how philanthropy can help communities to renew their perspectives on health care.

The keynote speakers spoke on very different subjects, but their messages overlapped.

Carlson said advances in healthcare came from philanthropic support.

"Philanthropy has been undervalued," she said in an interview before the regular program. "Look at what it has done for this valley . . . what you have done is extraordinary."

Carlson explained how donors voluntarily "lowered their own resources" to make St. Luke’s happen.

There are still many problems facing healthcare in the future like access, she said. "What can communities do to change unacceptable realities?"

She said change often happens in small ways with revolutionary thinking.

"The future will not be shaped by the majority," she said. "As a collective we are often dumber than we are as individuals ... the power of a community is to challenge the prevailing way of thinking."

"I hope someday we will find a way for everyone to have access to (universal health care)," Wilensky said, speaking about the role of government assistance in health care.

She said either the two public programs Medicare and Medicaid need to be opened up to more people who currently don’t qualify, or the government needs to provide support through things like refundable tax credits.

The two approaches should not be opposite and opposing, they could be used in combination, she said. "Whatever we do it will be messy."

Wilensky explained that Medicare now resembles how it was in 1991, when the number of uninsured in the United States was rising and there was fear about pressure on the program.

She also stressed a need for personal accountability, saying there needs to be regulatory reform so that distinctions can be drawn between good doctors and the "barely indictable."

She said she was surprised that the Senate passed a prescription drug bill. The bill is now headed for a conference committee. If a compromise bill does make it to the president’s desk, there will still be huge challenges to face and the baby boomers have yet to become patients in the program, she said

If a bill does not become law, critical access to hospitals will be at risk, she said, and there will be big impacts on many doctors’ practices. She anticipates yet more spending, but asks the question whether we can slow it.

"We are getting what we want and we are paying for it," she said.

"Physicians are paid for intervention with high technology to treat the sick," said Carlson, explaining that their goals are to intervene and "design out" disease. "Just considering the advances in anti-aging technology we are changing what it means to be old."

"But, we can’t afford to continue doing what we are doing," she said, offering an example. "We need to solve the malpractice crisis. We can’t tolerate that."

"What a different trajectory we would be on if we had had some sense of sufficiency," she said.

In the future, philanthropy can be given more attention, Carlson said. Philanthropy can be significant leverage for improvements and advancements in an institution, but something equally important is that it renews the "covenant relationship" with the community. Healthcare may go beyond simply providing medical care. It can go deeper into what is needed for health, education and economic access to resources.

 

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