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Top five recommendations for health-care reform from a Wall Street Journal CEO health-care panel

1. Fight obesity
Use the presidential office to drive home the prevention message. Make reducing the obesity epidemic the top priority for the new surgeon general and the Centers for Disease Control and Prevention, while addressing race-based health disparities.

"… fighting obesity is like motherhood and apple pie. You know we all love the idea that we can do something as simple as deal with obesity, make sure we're eating right and our kids are exercising, and we're going to avoid disease."

— Angela F Braley

2. Tort reform
Reform malpractice, using the National Vaccine Injury Compensation Program as a model. Create an environment that protects patients while allowing physicians to practice in high-risk specialities without facing prohibitively expensive insurance premiums.

"… the threat of litigation stifles the quality discussion, because we're in an environment where we cannot as clearly discuss errors and address them in a high-quality way."

— Angela F Braly

3. Define value, reform payment
Change the reimbursement system to reward preventive care and evidence-based care, and extend government efforts to no longer reimburse inappropriate, unsafe or wasted care. Move Medicare to a pay-for-value model. Define measurable outcomes for most common diseases … Redistribute Medicare payments to favour physicians who perform well….

"It's real easy for people to say we're not getting what we're paying for, which implies you know what quality is. Somebody knows it somewhere. So why don't we measure the elements of quality?"

— Denis A Cortese, MD

4. Build the health-care work force
Focus on primary care. Include registered nurses, nurse practitioners and allied professionals, as well as MDs. Make sure there are enough professionals to support increased access to care.

"If we want to stimulate jobs in this country, one of our great opportunities and one of our great distinctions as a country is in the sciences, in medicine, in well-paying jobs, and we can actually strike a blow here for two things we're trying to accomplish."

— Jeffrey B Kindler

5. Universal health coverage
Enact comprehensive healthcare reform, including universal access to affordable, quality insurance plans for those not covered by employer-based programs. Require individuals to buy insurance.

"We all have to keep an open mind on all this stuff, figure out how to get to yes. Everything is on the table. The only thing that is not on the table is a single-payer system. That's going nowhere."

— Senator Max Baucus

The panel participants:
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Angela F Braly, president & CEO, Wellpoint:
Denis A Cortese, MD, president & CEO, Mayo Clinic:
Jeffrey B Kindler, chairman & CEO, Pfizer
Daniel Vasella, MD, chairman & CEO, Novartis AG
Senator Max Baucus, D-Montana

Source: Wall Street Journal CEO Council, Nov. 24, 2008. For the video, blogs, podcasts, news and analysis on the subject go to www.WSJ.com/Reports

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