The document discusses the impact of the Affordable Care Act (ACA) on American employers. It outlines challenges facing employers, such as rising healthcare costs, new expensive benefit requirements, and uncertainty around the law's implications. The ACA could force employers to limit coverage, send employees to exchanges, or implement cost-cutting measures like wellness programs. Overall, the document examines problems in the U.S. healthcare system that make reform difficult and opportunities to improve the system and reduce costs for employers.

1. Political Malpractice: The Impact of the ACA
on American Employers
Speaker:
Stanley Hupfeld
Chairman
INTEGRIS Health Foundation
Moderator:
Max Mihelich
Associate Editor
Workforce magazine
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7. Political Malpractice: The Impact of the ACA
on American Employers
Max Mihelich
Associate Editor
Workforce magazine
#WFwebinar

8. Political Malpractice: The Impact of the ACA
on American Employers
Stanley Hupfeld
Chairman
INTEGRIS Health Foundation
#WFwebinar

9. POLITICAL MALPRACTICE
&
EMPLOYER CHOICES
Presented by
Stanley F. Hupfeld

10. TABLE OF CONTENTS
 Highs and Lows of American Medicine
 Essential Question
 Essentials of American Medicine
 14 Reasons Why the System is So Hard to Reform
 Formula for Employer Cost
 Understanding Law
 Employer Issues
 Opportunities to Improve
 The Reason to Act
 Appendix
 Q&A

11. HIGHS AND LOWS OF
AMERICAN MEDICINE
 12-Patient Kidney
Transplant
Three States
Nine Surgeons
Three Hospitals

12. HIGHS AND LOWS OF
AMERICAN MEDICINE
 Nation’s First
 Less Than Mile
Away
(CONT’D)

13. HIGHS AND LOWS OF
AMERICAN MEDICINE (CONT’D)
 Ying and Yang –
Best and Worst

14. ESSENTIAL QUESTION
 How to Deliver and
Pay For:
 High Quality Care
 Reasonable Cost
 Most People

15. ESSENTIALS OF AMERICAN
MEDICINE
 Retail Analogy

16. ESSENTIALS OF AMERICAN
MEDICINE (CONT’D)
 Not Insurance
 Transfer of
Payments

17. 14 REASONS WHY THE SYSTEM IS
SO HARD TO REFORM
1. Tort System

18. 14 REASONS WHY THE SYSTEM IS SO
HARD TO REFORM (CONT’D)
2. High Overhead
3. Medicine’s
Secret
4. Hospitals as
Part of the
Problem
5. Cost Shifting

19. 14 REASONS WHY THE SYSTEM IS SO
HARD TO REFORM (CONT’D)
6. History of
Entrepreneurship
 Social Service or a
Business
7. Lack of Continuity

20. 14 REASONS WHY THE SYSTEM IS
SO HARD TO REFORM (CONT’D)
8. Market Driven?
9. Unclear Expectations/
Our Rights as a
Patient

21. 14 REASONS WHY THE SYSTEM IS SO
HARD TO REFORM (CONT’D)
10. View of Death

22. 14 REASONS WHY THE SYSTEM IS
SO HARD TO REFORM (CONT’D)
11. Variation in
Treatment

23. 14 REASONS WHY THE SYSTEM IS
SO HARD TO REFORM (CONT’D)
12. We (Patients) Are Part of
the Problem
13. American Expectations

24. 14 REASONS WHY THE SYSTEM IS
SO HARD TO REFORM (CONT’D)
14. Our Words Are Part
of the Problem
 We Are the Best
 Death Panels
 Health Care Decision
 Only Between You and
Your Doctor

25. FORMULA FOR EMPLOYER
COST
$ = (# of Employees Covered) [EC]
x (Benefits) [B]
x (Use Rate of Those Benefits) [UR]
x (Provider Payments) [PP]
$ = EC x B x UR x PP

26. UNDERSTANDING THE LAW
 Individual Mandate,
Health Exchanges,
New Benefits

27. UNDERSTANDING THE LAW (CONT’D)
 Employer
Mandate and
Consequences

28. EMPLOYER ISSUES
 Increased Cost of
Care versus New
Expensive Benefits

29. EMPLOYER ISSUES
(CONT’D)
 Employer headache
 Employer Must
Control at Least One
Variable in Formula
 Employee
Dissatisfaction
 What is Competition
Doing?

30. EMPLOYER ISSUES
CONT’D
 Increasing Burden to
Employees
 Stop Coverage – Send
Employees to Internet
 Direct Contracting –
Cut Out Middle Man
 Private Exchange – Let
Employees Contract
Plan

31. EMPLOYER ISSUES
(CONT’D)
 Do Employers
Continue to Support
Financing Employee
Health Care?

32. EMPLOYER ISSUES
 Focus on Wellness
CONT’D

33. OPPORTUNITIES TO IMPROVE
 Implementation of Evidenced-Based
Medicine
 Standards for Information Technology
 Serious Tort Reform
 Use the Money Already in the System
 Stimulate the Emergence of a Not-ForProfit Insurance Industry
(for a complete list, see Appendix)

34. THE REASON TO ACT
 Lucy’s Story

35. APPENDIX
(PP 141-150 IN BOOK)
1.
Recommit to the Goal
2.
Public Debate
3.
Stimulate the Emergency of a
Not-For-Profit Insurance Industry
4.
Implement the Exchanges
5.
Give Employers Real Choice

36. APPENDIX
(CONT’D)
6.
Implementation of EvidencedBased Medicine
7.
Standards for Information
Technology
8.
Accelerate the Formation of
Accountable Care Organizations
9.
Physician Manpower
10. Clever Use of Tax Incentives

37. APPENDIX
(CONT’D)
11. Hospitals as Change Agents
12. Serious Tort Reform
13. States as Laboratories
14. Money Already in the System
15. End of Life Care

38. Q&A

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