Ezekiel Emanuel Optimistic on US Healthcare Future

— by Deborah Weinstein

The Jewish Social Action Policy Network held its 2012 Annual Meeting at the Pyramid Club in Center City Philadelphia on June 6, 2012. Guest speaker, bioethicist Ezekiel J. Emanuel, M.D., Ph.D., captivated his audience with the many reasons he is “optimistic about the future of the American healthcare system” and why he believes that it will be “vastly improved” by the end of the decade.

More after the jump.
Dr. Emanuel expressed confidence that the U.S. Supreme Court will find the Affordable Care Act constitutional when the Justices hand down their decision on the healthcare reform law later this month. In his view, there is “No doubt it is constitutional.” “Legally, this is an open and shut case,” he said.

The Court can and, he believes, will uphold the Act on grounds relating to the Necessary and Proper Clause, the Commerce Clause and the federal government’s taxing powers. Extolling the landmark passage of the Act by Congress (which he helped to craft), Emanuel traced what he described as “100 years of effort” by former U.S. Presidents and others to reform the country’s healthcare system.

The new chair of the Department of Medical Ethics at the University of Pennsylvania and Vice-Provost for Global Initiatives, Emanuel is also an Op-Ed contributor to The New York Times and founding chair of the Department of Bioethics at the National Institute of Health. During the Obama administration’s development of the Affordable Care Act, he served as a Special Advisor on Health Policy to the Director of the Office of Management and Budget and on the National Economic Council.

Dr. Emanuel began his remarks by focusing on the magnitude of the cost of the country’s healthcare system, which he said is the largest in the world. According to Emanuel, in 2010, the country spent $2.6 trillion dollars on healthcare, up to 50 per cent more per person than the two other highest-spending countries, Norway and Switzerland. The level of U.S. healthcare spending makes it the fifth largest economy in the world. It is growing by $100 million every year.

Despite this level of spending, Emanuel dubbed the quality of healthcare in this country as “average, no matter how you measure it.” “On no metric is this a healthcare system we should be proud of,” he said. It is a system that “doesn’t cover 50 million Americans” and where there is a 20 per cent chance of re-admission to a hospital within 30 days after discharge. This, he said, is both “indefensible” and “unacceptable.”

Viewing the present time as a “transition period when there is a lot of uncertainty and change,” Dr. Emanuel believes the system will be vastly improved by 2020. He envisions a healthcare system of the future that will be more cost conscious, more focused on higher quality of care and designed to provide less unnecessary care. He predicted that the healthcare system in this country will do a better job of coordinating care and rely on improved metrics about quality of care and assessment of doctors. “Comparative effectiveness research,” he said, “will provide us with better understanding of what treatments work. We have examples of systems that work” and know “solutions exist already.” The challenges going forward as Dr. Emanuel sees it will be to “invent ways to replicate solutions.”

At the conclusion of his presentation, Dr. Emanuel took questions from the audience, including long-time JSPAN members and guests. JSPAN Board President Brian Gralnick and incoming President Lynn Zeitlin, Esquire, concluded the formal portion of the program with a brief discussion of JSPAN, what its mission is as an organization, the impact it has already had, and how it plans to expand its reach in the future. President Zeitlin also recognized outgoing Board Treasurer Stephen Applebaum and JSPAN Policy Center Chair Susan Myers for their valuable contributions and diligent work for the organization.

 

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