Dr. Christopher Peters M.D. - Speaker, March 6, 2018

Dr. Chris Peters has spent over 30 years practicing medicine, mostly as a chest and vascular surgeon. His experience includes time in the military, a hospital setting, private practice and many other arenas. The vast array of opportunities has allowed him a unique perspective into the health care system. For most of his career, he thought things were fine, but over the last decade he has sought to better understand the problems facing our current situation. Even better, he offers solutions that can help solve these problems.

 

Most of the popular debate centers around two distinct arguments. One side is typically arguing for a system that resembles Medicare, but for everyone. The opposition is campaigning for a repeal and replacement of the Affordable Care Act. Dr. Peters believes the solution lies somewhere in the middle. Health care can be measured by the ABCs. They are Access (insurance), Benefit (is the provided care beneficial to the patient), and cost (price of care). Dr. Peter’s goal is to have equality of access, maximize the benefit of any particular intervention, and lower the cost of care.

 

About 1/6^th of America’s GDP goes towards health care costs, and that number is steadily approaching 1/5^th. Dr. Peters attributes this to five major influences. First, America has many health care systems within the whole (Medicare, Medicaid, Employer-based insurance, Private-pay insurance, Fee for service, etc.). Secondly, there are astronomically high administrative costs associated with health care. 20-25 cents per dollar go towards administrative costs. Third, there is a very high cost per unit of care, meaning the actual cost of an exam or procedure have increased. Next, is general over-utilization of the health care services. Not only do we have more expensive “units” of health care, but we are using them more and more. Dr. Peters used the example of the MRI rates in America compared to other countries. Our MRIs tend to cost a lost more, and doctors tend to order this imaging much more frequently as well.

 

Dr. Peters argues that the fifth factor is the most influential: 3^rd party payers. The injection of a comprehensive insurance model has numbed individuals to the actual cost of a good or service. Instead of asking, “How much does this cost?” people are asking, “Is this covered by my insurance?” This paradigm shift has completely changed the way people approach health care.

 

His vision for health care is to support those who really need it (chronically ill or severe diseases are examples). 5% of the population accounts for 50% of the health care costs. Dr. Peters argued that it is a moral obligation for a society to take care of those who cannot take care of themselves. Next, we must empower patient decision making. The individual has become removed from the decision making process. Finally, we need to reintroduce free market forces into the health care system. Currently prices are being dictated from a top-down approach, instead of a bottom up. When massive health care providers do not have to compete, there is no incentive to offer an affordable price.

 

Dr. Peters believes this can be accomplished by reforming health insurance to move towards a high deductible plan with an emphasis of the Health Savings Account (HSA). This will force individuals to be more selective about how and when they access care, but will also have them protected in the case of a catastrophic event. We need to push health insurance to be more like auto and home insurance. In the same way that those policies do not cover gas, oil changes, a new couch or exterior paint, health insurance should not be expected to cover elective procedures. Furthermore, diligent saving from an early age can also help to mitigate the problems we face with social security and medicare costs. He also mentioned that we need to revise intellectual property laws, which would help tackle the challenges we face with the pharmaceutical industry. Unfortunately, due to time, he did not have a chance to explore this topic further with us.