David Cutler, the Otto Eckstein Professor of Applied Economics at Harvard University Department of Economics, will give the 19th Hogness Symposium on Health Care lecture Friday, Nov. 13, from 3 to 4:30 p.m. in Hogness Auditorium, A-420 Health Sciences Center. The title of his lecture is Health Care Reform: The Real Story.
Cutler has served on the Council of Economic Advisers and the National Economic Council during the Clinton Administration and was senior health care adviser to Barack Obama’s presidential campaign. He is the author of Your Money or Your Life: Strong Medicine for America’s Health Care System (Oxford University Press). He was recently named one of the 30 people who could have a powerful impact on health care by Modern Healthcare magazine. Cutler is also a research associate at the National Bureau of Economic research and a member of the Institute of Medicine.
Cutler’s work in public economics and health economics has earned him academic and public acclaim.
At the beginning of his career, Cutler said he was mostly interested in government spending and public sector economics, but that changed over time.
“When the role of health care became prominent on the public agenda in the ‘80s, I realized that there was an inevitability that the economics of the government sector and the private sector have to be simultaneously embraced in the discussion of health care reform. You can’t embrace one without the other,” he said.
In current health care reform discussions, the debate about the public option has received the most media coverage, but Cutler contends that that’s not the key issue in health care.
“Public options matter, but the real story revolves around two things: One, How are we going to get health care coverage to all Americans and how are we going to pay for it. Two, How do we provide higher quality health care at lower costs. Health care reform must be about those two issues.
“Most experts believe that America’s health care could be made less expensive and of higher quality, simultaneously. We’ve got to talk about incentives for true health care reform.”
Cutler said that the current health care economy in the United States is based on sickness rather than on health.
“Doctors get paid for seeing more patients and performing more procedures, but not for delivering high-quality and cost-effective medicine,” he said. “We should be talking about making keeping people healthy as being more lucrative than keeping them sick. We should be talking about making it more lucrative to work with people for their health, than abandoning them when they are sick.”
Cutler, as an adviser to the Barack Obama presidential campaign, has noted that rewarding hospitals and doctors for patient outcomes; identifying best providers, treatments and patient management strategies; and guaranteeing access to preventive services are among the most cost-effective ways of delivering high quality health care. Ultimately, Cutler said, health care reform will depend on the participation of everyone — patients, health care providers, insurers, and government.
“People have to trust that the system is designed to work for them.”
Cutler said he is optimistic about the progress being made in designing a health care package that makes high-quality cost-effective health care more accessible to more Americans. He added that the Puget Sound area could be a model for the rest of the country.
“Medical care in the Puget Sound area is extremely high quality and a model for the country. There’s an ethic in the area that caring for patients is important and not just making money. That’s not true in all parts of the country. You don’t see that ethic in areas of the country that are poor health care performers.”