It's time to dine together

I recently had the opportunity to visit with old friends and enjoy dinner together.  During our time, we were reflecting on each of our life's journeys and how we experienced different life events that helped shape us as individuals.  As I listened to their stories, I gained a greater appreciation for the unique personalities that had been molded over the years based on these experiences.   By understanding their stories of life, I may not agree with how their situations or problems are handled but I have a better understanding of their "context."

With passage of the healthcare reform bill, and as the dust starts to settle on what is actually is in the bill, it will require many entities that in the past were viewed as potential "enemies" to now sit down and dine together and understand how we will work in the new normal.   As Stephen Covey wrote in his bestselling book, "one must first understand to be understood" and for healthcare to move in the right direction, we are going to need a whole lot of understanding. 

Judy Miller, editor-in-chief of Managed Healthcare Executive commented in its April, 2010 issue that "of all the players seated around the healthcare reform table, payers are the only ones challenging the cost of care, and yet, they're the ones getting the beating.  They know $20 for two aspirin is a rip-off, but no one is listening."

 She is right.  The payers are taking a beating in the press, and yet very few people are addressing the irrational charges being passed on to the payers and consumers of healthcare.  Payers AND providers must "sit down at the table" and understand that a rational approach to controlling the cost of healthcare is the elephant in the room. 

Both sides need to better understand the pressure points driving this irrational behavior.  As Karen Ignagni, President of AHIP recently said, "To suggest that cost containment can be achieved by singling out health plans ignores the very inconvenient truth that premium increases reflect increase in the underlying cost of medical services.  Regulating premiums won't do anything to reduce the soaring costs of medical care.  This would be like capping the prices automakers can charge consumers, but letting the steel, rubber and technology manufacturers charge the automakers whatever they want."

 Since 1994, NCN's mission has been to provide a rational, defensible and transparent payment methodology that strives bring the payer, provider and, at times the consumer, to the table to discuss openly what is a rational payment for care.