Are you ready for health reform?

Health reform is not simple, predictable or completely defined – but it is here to stay. It is a moving target that presents individuals, government agencies and organizations in every industry with critical choices that will play out for years to come. This video highlights many of the key statistics that are shaping and informing these choices.

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About the Video

The architects of health reform have taken on a transformative challenge, setting in motion new forces that eventually will have to find equilibrium. Rising costs vs. individual and employer mandates. Increased demand vs. a potential shortage of doctors. And more. Despite the uncertainty, no organization that touches health care can afford to sit this process out. The first steps? Learn what you can and define the choices you have to make now and in the future.

Have specific questions about any of the statistics used in this video? Review the detailed sources below.

To access our complete library of health reform resources, visit www.deloitte.com/us/healthreform.

Endnotes (in order of appearance)

1. Seventh largest economy: “Health Care Reform: The Perils of Inaction and the Promise of Effective Action,” Business Roundtable, September 2009.
2. Per capita health spending: NHE grew 4.4 percent to $2.3 trillion in 2008, or $7,681 per person, “National Health Expenditure Fact Sheet,” Center for Medicare & Medicaid Services, February 3, 2010. May 25, 2010.
3. Per capita GDP: United States = $7,519.56 per capita GDP, “Economy Statistics > GDP per capita (1975) by country,” Nationmaster.com. May 25, 2010.
4. Percentage of patients and health care spending: Schoen, Cathy, Sara Collins, Jennifer Kriss, and Michelle Doty, “How Many Are Underinsured? Trends Among U.S. Adults, 2003 and 2007,” Health Affairs, Published online June 10, 2008.
5. Wasted health spending: Fisher, Elliott S., Wennberg, David E., Stukel, Thérèse A., Daniel J. Gottlieb, Daniel J., Lucas, F.L., and Pinder, Étoile L. “The Implications of Regional Variations in Medicare Spending. Part 1: The Content, Quality, and Accessibility of Care.” Annals of Internal Medicine, February 18, 2003, 138:273-287
6. Redundant clerical work: “Analyzing the cost of administrative complexity, new research findings support current initiatives to simplify health care payment system.” Medical Group Management Association (MGMA) Center for Research. September 2004.
7. Health care fraud recoveries: U.S. Department of Justice as reported in “Fact File,” Health Care Reform Memo, Deloitte Center for Health Solutions, May 17, 2010.
8. Sales representatives and health care lobbyists: Sufrin, CB and JS Ross, "Pharmaceutical industry marketing: understanding its impact on women's health,” Obstetrics Gynecological Survey, 63 (9), September 2008, p. 585–96.
9. System rewards quality: “Primary Care Doctors’ Reports of Any Financial Incentives for Quality of Care Improvement,” Commonwealth Fund International Health Policy Survey of Primary Care Physicians, 2006, as reported by Karen Davis, President, The Commonwealth Fund, during her Invited Testimony, “Closing the Quality Chasm: Opportunities and Strategies for Moving Toward a High Performance Health System,” United States Senate Committee on Health, Education, Labor, and Pensions, January 29, 2009, Slide 32.
10. Deaths due to lack of insurance: "Health Insurance and Mortality in US Adults," American Journal of Public Health, Vol 99, December 2009.
11. Uninsured with jobs: “Health Care Reform: The Perils of Inaction and the Promise of Effective Action,” Business Roundtable, September 2009.
12. Health-related bankruptcies with insurance: Himmelstein, David U., Deborah Thorne, Elizabeth Warren, Steffie Woolhandler, “Medical Bankruptcy in the United States, 2007: Results of a National Study,” American Journal of Medicine, Volume 122, Issue 8, August 2009, p. 741-46 (744).
13. Uninsured Americans: Income, Poverty, and Health Insurance Coverage in the United States: 2008, Census.gov, September 10, 2009. May 26, 2010.
14. Increased Employer Health Plan Coverage: March 18, 2010, Congressional Budget Office estimate.
15. Medicaid changes under PPACA: Foster, Richard S., “Estimated Financial Effects of the Patient Protection and Affordable Care Act as Amended,” Centers for Medicare & Medicaid Services, Office of the Actuary, April 22, 2010, p. 3-4, Table 1.
16. Cost of expanded coverage under PPACA: Foster, Richard S., “Estimated Financial Effects of the Patient Protection and Affordable Care Act as Amended,” Centers for Medicare & Medicaid Services, Office of the Actuary, April 22, 2010, p. 2-3, Table 1.
17. Average insurance premium vs. penalty: These figures were obtained from the following sources:
    • Employer Health Benefits 2009 Annual Survey: Summary of Findings, The Kaiser Family Foundation and Health Research & Educational Trust, September 15, 2009, p. 1, Exhibit B.
    • The Patient Protection and Affordable Care Act and related Reconciliation bill (HR3590, HR4872), Section 1501 as amended by 10106 and R-1002, March 23, 2010, March 30, 2010.
18. Health Savings Accounts: Fest, Glen., “HSA’s High Hurdles,” US Banker, January 2010.
19. Individual vs. employer penalties: Foster, Richard S., “Estimated Financial Effects of the Patient Protection and Affordable Care Act as Amended,” Centers for Medicare & Medicaid Services, Office of the Actuary, April 22, 2010, Table 1.
20. Retail clinics: Keckley, Paul H., Underwood, Howard R., and Gandhi, Malay, “Retail clinics: Update and implications,” Deloitte Center for Health Solutions, 2009.
21. Increase in consumer health care spending: Sisko, Andrea, Christopher Truffer, Sean Keehan, John Poisal, Kent Clemens, and Andrew Madison, “National Health Spending Projections: The Estimated Impact of Reform Through 2019,” Health Affairs, October 2010, Exhibit 1.
22. Use of Electronic Medical Records (EMRs): These statistics were obtained from the following reports from The Commonwealth Fund:
    • Schoen, C., et al., "A Survey of Primary Care Physicians in Eleven Countries: Perspectives on Care, Costs, and Experiences, 2009," The Commonwealth Fund 2009 International Health Policy Survey of Primary Care Physicians in Eleven Countries, as reported in Health Affairs Web Exclusive, November 5, 2009, w1171–w1183.
    • “100 Percent of Primary Care Doctors in Denmark Use Electronic Medical Records,” News Release, The Commonwealth Fund, March 11, 2010. Accessed on May 25, 2010.
23. Savings from HIT and EMRs: Goodman, Clifford, “Economics of Health Information Technology: Savings In Electronic Medical Record Systems? Do It For The Quality.” Health Affairs, September 2005 24:51124-1126; doi:10.1377/hlthaff.24.5.1124
24. Qualified HIT workers: A Message from Dr. David Blumenthal, the National Coordinator for Health Information Technology, “The Health IT Workforce Development Program: Help Is on the Way,” October 12, 2010, accessed at http://healthit.hhs.gov, accessed February 3, 2011.
25. Federal Reforms vs. Repeal: The statistic is based on the following reforms passed and repealed in the last 60 years:
    • Tax exemptions for health insurance benefits (1954)
    • Creation of Medicare/Medicaid – Social Security Act (1965)
    • Federal HMO Act (1973)
    • ERISA (1974)
    • COBRA (1986)
    • Medicare Catastrophic Care Act (1988)
    • HIPAA (1996)
    • BBA – CHIP and Medicare Part C (1997)
    • MMA – Part D (2003)
    • ARRA/HITECH (2009)
    • PPACA/HCERA (2010)
    • Medicare Catastrophic Care Act - repealed 12/89

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