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Arc Fusion Dinner, Boston 2015

Arc Fusion Dinner, Boston 2015

Arc Fusion Dinner
Boston
October 22, 2015

Money: Are we insane?

The cost of healthcare and how to pay for the future

Money

Nightline - The Anatomy of a Hospital Bill

ABC News - The Anatomy of a Hospital Bill, aired in 1993. This Nightline Special illustrated the cost of healthcare by assembling in one room every person, machine and pill used in one man’s heart bypass operation. Total Bill: $63,000. This teed off our evening with the question: What has changed in the last 22 years?

Around 70 Arc Fusion Dinner attendees  plunged into an evening and a discussion about the cost of healthcare in the US, and what, if anything, should or could be done about it. Most speakers believed that health care costs were worth it if Americans were getting a good value for their money. However, most agreed this is not the case. We also heard some real-life innovative solutions to spending less and producing greater value.

What people said

I think the issue is it's really not how much we spend, but let's make sure we're spending those dollars intelligently.

Jonathan Bush

And why is it that in every sector of the economy, we're thinking faster, better, cheaper, except in the two that matter? Which are education and healthcare.

Juan Enriquez

When you think about how companies are getting started, what are the kinds of things that we reward entrepreneurs, CEOs, for? Do we reward them for taking big risks?

Daphne Zohar

Unfortunately, humble and patient are not two words you'd use to describe politicians... it's up to this expert community to really help convince the leaders that we need to take our time and get this right.

Jon Grubber

Consumers are way too disengaged in the purchase of healthcare today.

Steve Wiggins

More talks on the way

Program

Boston Arc Fusion Dinner 2015

Theme: MONEY: Are we insane? The cost of healthcare and how to pay for the future
Commander’s Mansion, Watertown, Massachusetts

5:30: Reception

Music: Violin and Cello by Double Helix

6:30: Program

Video: “The Anatomy of a Hospital Bill”, ABC Nightline, 1993
Special Guest: Richard Harris, former Executive Producer, ABC Nightline

Welcome:

David Ewing Duncan, Arc Fusion
Bryan Speilman, Medidata
Jonathan Bush, AthenaHealth

MONEY: An Introduction to our evening’s theme

David Ewing Duncan

Arc Fusion Talks

Jamie Heywood, PatientsLikeMe
Daphne Zohar, PureTech Ventures
Steve Wiggins, Remedy Health
John Fallon, Blue Cross
Jonathan Gruber, MIT (former White House)

Arc Fusion Discussion

Jonathan Bush, AthenaHealth
Juan Enriquez, Excel Venture Management
John Brooks, Joslin Diabetes Center

8:00 pm: Arc Fusion Dinners – Six Tables

Dinner Produced by Michael Hebb
Wine by Trefethen

Table Talk Questions (everyone answers):

"Are you getting good value for what you spend on healthcare? Is society?"

"We are smart people - what can you do to reduce healthcare costs?"

Table 1: Table Talk Leader: Juan Enriquez
Table 2: Table Talk Leader: Daphne Zohar
Table 3: Table Talk Leader: Jamie Heywood
Table 4: Table Talk Leader: Bryan Spielman
Table 5: Table Talk Leader: Jonathan Bush
Table 6: 
Table Talk Leader: Taylor Milsal

9:00pm: Dessert

Tcho Chocolate and Whiskey

Arc Fusion Dinner: Table Talk Leaders

Table 1

Juan Enriquez
Table Talk Leader

Selected comments:

“We need a real cultural shift; patients to take responsibility for their own health. We need a better education system for people who don’t have the time and the resources to understand what mechanism is best for their health.”

“My gut tells me we’re not getting a good deal – we’re way overspending. I find it very daunting, very confusing, very partisan…We’re having a heart attack as a country now and it’s called partisanship…we’re torn apart at our center.”

“I think that what we need to do as thought leaders is move beyond the questions like” ‘is it of value, questions which are fun to think about at dinner, but which don’t actually help. We think more about what we can we do on the margins, to make it better, to improve the value…What we have to do is think small. It’s so much more fun to think big, but thinking big runs into the ugly reality of politics…'

“It would be interesting to think about the next 100 years – we’re going to have an aging society. If we don’t do something what will be the real cost?”

“Where do we stand historically in life science research? We don’t even know what Alzheimer’s is…how do we advance life science research to make discoveries faster. And I think we are systematically underinvesting in the enabling technologies in life science research.”

Look for more notes, questions and ideas to come.

Table 2

Daphne Zohar
Table Talk Leader

Selected comments:

“Lot’s of people die from ignorance of the system and not knowing how to navigate it.”

“As a personal question most of us are getting good value for our health care, but as a society we’re not.”

“Healthcare is variable, even when you can afford it. We don’t have a good way to measure and therefore we can’t optimize.”

“We here at this table take healthcare as a given. What about the people who are not as educated as we are? How do they interact with the healthcare system and what do they get out of it?”

“Doctors are not properly incentivized – at times they will go for costly procedure because they get reimbursed more.”

“Patients need to take control and we need to give them the resources to do it.”

“Developed countries are set up to promote diseases and not wellness…can we shift this?”

Solutions:

  • Education
  • Technology
  • Economic incentives

Look for more notes, questions and ideas to come.

Table 3

Jamie Heywood
Table Talk Leader

Selected comments:

“The only thing I get value for is stuff I pay cash for. The stuff that goes through the system is a disaster. I don’t believe personally it’s fixable. I’m interested in building new systems.”

“After 25 years I have come to realize that maybe a single payer system works.”

“We all share a little bit of guilt in that we all profit from this broken system.”

“I want to live longer – will I get that from this system?”

Look for more notes, questions and ideas to come.

Table 4

Bryan Spielman
Table Talk Leader

Selected comments:

“There’s very poor communication between the health sciences and the general public.”

“There needs to be more transparency in what we are paying for.”

“We spend more in Massachusetts than any other state. What should we spend on health care? We need to spend less. Our only hope is stopping fee for service.”

“The informed consumer doesn’t know what to do.”

“There’s a good argument in favor of single payer. It’s going to happen one day – rather sooner than later.”

“Look at life expectancy – it’s hard to say we’re not getting value.”

“What is the right contribution? Look at education, look at defense. It’s all connected because it’s all tied to money.”

Look for more notes, questions and ideas to come.

Table 5

Jonathan Bush
Table Talk Leader

Selected comments:

“I’ve seen the wonders of the system and I’ve seen the waste in the system, partly due to incorrect incentives, partly due to people trying to make money on fee for service. When thinking of any system we have to think about the compassion, the communications, the connectivity among family and providers…Maybe we’re spending enough, but we’re not spending it in the right places.”

“How can you manage healthcare costs if you can’t find out how much it costs?”

“Is there too much testing?”

“I’m optimistic that technology is helping, but I’m pessimistic because when we know more, there’s more stuff. I’m optimistic because we are getting healthier, but I’m pessimistic about the causes.”

“Although I believe healthcare is a privilege I believe it should be viewed as a right. It’s important that we take care of others. It’s important that we look at healthcare as something that everybody should have access to. Period.”

Look for more notes, questions and ideas to come.

Table 6

Taylor Milsal
Table Talk Leader

Selected comments:

“Would you trade 80% of you net worth for an extra 5 or 10 years?”

“The care system is sick and needs radical change.”

“If we want something that’s a self-working system you have to get incentives in line.”

“We need to introduce a system with transparency.”

“Are we spending money efficiently? If spending more gets you better health, is it worth it?”

“We spend most of our health care on end of life.”

“Incentives drive behavior.”

“Are we spending too much? The question is more about efficiency.”

“Protocols are designed to maximize profits.”

Look for more notes, questions and ideas to come.

Arc Fusion Poll

Before each Arc Fusion Dinner we ask our guests to answer some simple survey questions about our theme. Below are the questions and answers we asked on our theme: MONEY: Are we insane? The cost of healthcare and how to pay for the future.

Question 01

Question 02

Question 03

Question 04

Question 05

Question 06

Arc Fusion Photo Gallery

Lead

Disruptor

Agent of Change

Thanks to Trefethen Wines and Tcho Chocolate