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Bridging the Gap: Affordable Health Care for New York's Uninsured

31
Thursday July 2008

PAUL HOWARD: I am a senior fellow and the director of the Manhattan Institute’s Center for Medical Progress. I'd like to welcome everyone here, on behalf of the Manhattan Institute and our cosponsor, the New York State Health Foundation. The Center for Medical Progress encourages the development of market-based public policies to promote medical innovations and improve public health. We are proud members of the New York State Health Foundation's Coverage Consortium, which is dedicated to expanding access to more affordable insurance options for New York's uninsured. As our own Tarren Bragdon has pointed out in his "Rx NY" report, it is critical that we have a healthy, well-functioning private-insurance market to ensure that scarce public dollars are reserved for providing health-care assistance to our poorest and sickest citizens. But in maximizing help for the needy, we must also be cautious that regulation of private-insurance markets does not exacerbate the problem of the uninsured.

Our first panel will examine how state regulation of insurance markets affects the affordability of insurance, and the panel will suggest innovative ways to make New York's individual direct-pay market more responsive to the needs of today's workforce, including the young, relatively healthy consumers who may find themselves switching jobs frequently and thus poorly served by traditional, employer-based insurance options.

Our second panel will focus on the entrepreneurial companies and physicians who are changing the ways that patients interact with the health-care system. Physicians are opting out of traditional insurance arrangements while creating new formats that promote a true medical home. Convenient-care clinics are springing up in retail outlets that offer rapid access to routine and preventive care, complementing the primary-care system and, one hopes, reducing the strain on our overburdened emergency rooms. We have heard a lot over the last month, particularly from the Dartmouth Atlas of Health Care, on pricing disparities in the treatment of chronically ill patients, even among America's best hospitals. Today, we'll hear how some companies are finding ways to arbitrage these prices and quality differences in order to lower health-care costs and improve patient care. Our second panel will conclude by looking at how one state, Georgia, is trying to cover more of the uninsured by leveraging market forces.

Our keynote speaker is noted Harvard Business School professor and Manhattan Institute senior fellow Regina Herzlinger, who will offer her reflections on how to unleash innovation in health-care markets. Regina has recently written a book titled Who Killed Health Care?—and I think that her answer is that we have all had a hand in the death. The first thing I think that she'll ask us to do is to stop making decisions for patients and to empower them to make their own choices. But I'll let her explain how she sees that happening.

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