Safeway’s costs have gone down 20% (including employee premiums) in the last two years. How? Safeway went from $750 deductible to a $2000 one, but they put $1,000 in an HRA (not an HSA note—they’re not stupid!). All preventative care was free and they had an immediate payback. They added an HRA for employees and will do it for families. Burd says that just passing on the costs to workers without attacking the problem at source.

Burd believes that we should redesign the plan for government employees—especially the US Congress! We can use the savings to fund the uninsured.

Safeway is building a coalition of business leaders and pushing for a national coalition. They’re also involved with the Wyden plan and pushing the Schwarzenegger plans. 5 basic principles.

Market-based
Universal system
Financial assistance for low income individuals
Healthier behavior promoted
Equal tax treatment

If we do this across the board Burd believes that we can reduce costs in two years to 0% increase.

Phil Bredesen (Democratic governor of Tennessee, and former HMO exec) said that Tenn has a new small business program which offers insurance to small business. Just started in April. Looks like it might move to solve the small business problems.

Reed Tuckson from United HealthGroup, talked about their attempt to seek common ground with FamiliesUSA. And eventually has got everyone in the room including Heritage, AARP and AHIP, AMA, AHA etc. They announced that January 18 on key priorities—building on existing public/private solutions. Focus on those who are most vulnerable. Focuses on getting. Meant that everyone had to choose their “second best choice”. This is showing up in Congress in Ron Emmanuel’s kid initiative. “If you stand on your principles, my way or the highway, then nothing gets done”

Burd has spoken to 200 CEOs and says that all of them agree — everyone should have universal coverage. This is unprecedented.

David Gergen asked, “don’t CEOs just want to get health care off their backs.” Burd says that if you turn it over to goverment costs will keep going up. He then trots out the rubbish about cancer care and says that costs are a problem in other countries, which he needs to stop talking about if he wants a genuine debate.

Simmons then points out the requirements for competition to work in health care (Enthoven managed competition principles) have never been established. Burd says that government has a role but a limited one. Tuckson claims that this is being done…we have to keep moving. “Paralysis by analysis we don’t need”

Bredesen wonders how much of Safeway’s savings are the Hawthorne effect, but to solve it people have to believe that whatever happens will not hurt them

Gergen asks: who will resist? Bredesen says, the medical economy. “it’s one thing to put these people together to agree on general principles. It’s another to tell the AMA that fee for service medicine may need to change, to tell the AHA that you’re going to change the way hospitals get paid.”