With biting jokes and startling facts, Uwe Reinhardt, a professor of economics and public affairs at Princeton University, captivated an audience that included MSU President M. Peter McPherson.
Reinhardt was speaking at the annual Michigan Health Policy Forum, held Monday at the Kellogg Center.
The forum is an organization made up between the colleges of Human Medicine, Nursing and Osteopathic Medicine.
The group began 15 years ago to discuss health issues among local authorities. Today, national speakers come to discuss topics with members, who include various people in the health and medical community.
Reinhardt, who is considered a leading authority on the business of health care, spoke on the topic Health Care in the New Millennium: Who Will Manage It?
In the future, he said, health care facilities should look to pay nurses much more money for the work they do, public officials should allocate money for information to help doctors keep up with evolving practices and make medications more accessible to the elderly.
I tend to think of the health care system as a huge elephant, lumbering down the jungle path, basically with a mind of its own, he said. And you have policy-makers, these little people at the bottom, beating the legs of the elephant with sticks saying I want you to move to the left, or Now, or Move to the right.
Reinhardt said there is a difference in health care today vs. 20 years ago. In the past, he said, patients and their physicians managed the health care received by patients jointly without any external constraints on their decisions, other than medical practice acts.
You go to the doctor, you make it to the hospital and you go either home, to heaven or hell, he said.
In the early 1990s, he said, managed care hit the health care system with a two-by-four. The theory behind managed care called for distinct health plans that would serve the entire population, he said.
Only the physician and his or her patient should decide how to treat a particular illness, he said.
Reinhardt said while most ill health is due to peoples lifestyles and managing health is very important, there are other factors.
What you do today can really hurt you when youre 40, he said. But the other thing is, ask to what extent this is a community and to what extent are you just all on your own?
McPherson told the audience he was interested in Reinhardts comments on nurses.
We should pay nurses more. I think it is going to come, but we better be prepared as we pay nurses more to give them more authority, he said. The way to justify higher salaries is to in fact have more value added by the nursing services.
David Nerenz, director of health care studies for MSUs Institute for Managed Care, said he was left with the question of who is going to take up the management of health care in the future.
There may be no clear answer to who will be managing care; there are a number of choices and none of them are perfect, he said.