By Matt Golosinski
Kellogg School of Management
“This obesity thing is going to eat us alive if we don't do something about it,” said former president Bill Clinton during a keynote address at the Kellogg School on May 19.
Mr. Clinton spoke about a range of health issues facing the United States during his appearance at the “Perspectives in Healthcare Forum,” co-sponsored by the Huron Consulting Group and the Kellogg School of Management. The daylong event brought together healthcare leaders to consider several challenges facing their field, including an aging U.S. population, rising health costs and issues related to access, efficiency and quality of care.
“One of the great things about being an ex-president is you can say whatever you think,” said Mr. Clinton, smiling. “One of the bad things is no one has to pay any attention.”
But the invited guests - mostly senior leaders in healthcare and related sectors - did listen as Mr. Clinton candidly surveyed the contemporary landscape confronting patients, medical professionals and insurance companies. He revisited an initiative - The President's Task Force on National Health Reform - from early in his first presidential term, insisting that the scope of his administration's efforts to reform healthcare was largely misrepresented in the media - and hijacked by special interest groups - leading to the effort being disbanded.
“I continue to be plagued by the inability to change our healthcare system while in office,” said Mr. Clinton, noting that other presidents, including Truman, had been “pilloried as Communists” because of their belief that every American should be entitled to reasonable health coverage.
Mr. Clinton cited figures such as the 16 percent of U.S. GDP that Americans spend on healthcare overall, a number that he said still leaves 15 percent of people totally uninsured, even though the system is more expensive than all other advanced countries, which are spending about 10 percent to insure nearly 100 percent of their citizens.
“You pay $300 billion a year to pay people to go to work each to engage in a giant tug-of-war over what is covered and what isn't,” said Mr. Clinton, referring generally to the health insurance industry. “We spend 34 percent on administrative costs [related to healthcare]” compared to 19 percent in other countries, he added.
Competitors, such as Japan, said Mr. Clinton, have devised effective systems that enable them to spend less on healthcare and allocate more resources to pursuing successful commercial endeavors. “They beat our brains out in the automotive industry,” said the former president, who has made it a priority to address such health issues as childhood obesity, a problem he said is now “sweeping the world,” showing up in countries such as Ireland and India, among other places.
Mr. Clinton addressed issues including rising prescription drug prices, saying that U.S. citizens pay more than anyone else in the world for pharmaceuticals, including three times more for the same drugs than Canadians. He highlighted another circumstance contributing to high health costs: extraordinary care for the very old and ill.
“We spend more money on the last two months of life than anyone else,” said Mr. Clinton. He indicated that encouraging people to draft living wills would permit Americans to remain “consistent in our moral and ethical values” while helping lower healthcare costs. Encouraging more people to pursue healthy habits, such as good diet and exercise, would increase the chances of them living longer and “dying with their boots on,” meaning they would remain more productive for their entire lives, resulting in additional revenues that could help support initiatives to provide better care for all Americans, said Mr. Clinton.
With respect to another leading factor in healthcare costs, Mr. Clinton said that “lifestyle choices,” including gun violence and diet, play a significant role in the current crisis.
“The current administration's idea of reducing the number of police and increasing the number of weapons on the streets doesn't make any sense, and it's a healthcare issue,” he said, in what was largely a speech encouraging nonpartisan solutions to a collective challenge.
Mr. Clinton said Americans should avoid the “rhetoric and demonizing” that often surrounds the healthcare issue and instead elect representatives who will “get about to solving the problems.”
While he admitted that the solutions to the healthcare situation would prove formidable, Mr. Clinton offered several possible strategies to begin transforming a system he indicated was in dire need of change. Some of the tactics, he said, should garner easy support regardless of political affiliation.
“Electronic records will help enormously,” said Mr. Clinton. “It's nuts for us not to do this.” He said that savings of about $100 billion could derive from moving to an electronic data system.
He also said that ideas proposed by people such as America Online co-founder Steve Case could make an impact. Case has been a proponent of small, low-cost health clinics located in shopping malls and other nontraditional areas.
With respect to childhood obesity, Mr. Clinton has recently been active in helping reduce or remove carbonated beverages from school grounds, noting that the high fructose corn syrup in such drinks is one important component in the growing health problems facing younger Americans. Other factors, he said, include a more sedentary life - a fact in part influenced by shrinking academic budgets which in turn lead to fewer athletic programs. In some neighborhoods where gang violence is prevalent, children can find themselves with even fewer exercise options, he said.
Healthcare is “an issue of social justice and it's just wrong for us to be out of step,” said Mr. Clinton, noting his belief that a policy of cutting taxes for the richest top fraction of Americans is hurting the majority of citizens, including taking a toll on the nation's health system.
“I'm old-fashioned. I grew up in Arkansas and I believe in arithmetic,” said Mr. Clinton, indicating the connection between less government revenue and a deleterious affect on public services. “We have got to pay for certain things.”
“As soon as I left the White House, arithmetic did too,” he quipped.
He ended his address optimistically, saying that Americans can and want to solve healthcare challenges. Ninety percent of the people in his tax bracket, said Mr. Clinton, would gladly give back some of the money from tax breaks enjoyed under policies enacted by President George W. Bush if doing so would help the country.
“I've talked to enough of them to know,” said Mr. Clinton. “And sooner or later, we're going to have to.”