[Music]
when Warren Buffett addressed the
audience at his annual shareholders
meeting this year as a respected
business leader and thought leader the
audience expected to hear his take on
corporate tax reform and the benefits
afforded to his business as a result but
Buffett took the occasion to send an
entirely different message in truth he
said a Spectre far more sinister than
corporate taxes looms over corporate
American business and that issue is
health care cost nobody went on to say
was that health care costs are rising at
a rate so rapid right that they are
consuming the profits of corporate
businesses and he set it up this way
he says compare that the corporate tax
rates versus health care expenses over a
period of time and so we went back to
the 1960s and said corporate tax as a
percent of GDP or the value of the
economy was 4% in the 60s but today that
number is just 2% of the value of our
economy well keep that in perspective in
terms of the magnitude but let’s look at
health care cost over that same time
period 50 years ago healthcare costs
comprise just 5% of the value of the
economy overall today they comprise 17%
and growing there’s no end in sight
greater than three times approaching
four times what they were and so now you
can appreciate why Buffett and every
business leader and you and I should
also be so concerned about this cost now
a Buffett didn’t do is talk about the
ways that we can reduce cost but I can
assure you there are things that we can
do and we must do to reduce cost but
also improve quality and improve the
patient experience and we need only look
to other industries that have already
done this they’ve solved equally complex
problems with resources that are very
similar so where do I get the confidence
to say this why why do I have such
conviction well I came out of a
different space before healthcare I was
involved in manufacturing specifically
contract electronics manufacturing and
in that environment we had
stammers like General Electric and
Siemens and juniper Networks and these
customers were extremely demanding with
regard to product functionality but also
with regard to cost quality in the time
that we would deliver and so we
literally had to put a team of people
together to meet the demands of these
organizations so we had our design team
from product design as well as our test
engineers our manufacturing staff and
our procurement folks the folks that
bought the parts that were going to be
used all together around the table to
design these products to meet their need
and we got good at this right we got so
good at this in fact that we were known
for it so we’d take product out of
design get it through prototyping into
low value manufacturing high volume
manufacturing and making a profit or
revenue for our customers quicker than
anybody else and we’d call this process
time – revenue and we’d measure
ourselves based on our ability to get
product from design to revenue as
quickly as we could now we thought that
was pretty good and we felt good about
ourselves delivering that particular
service but our customers said that
wasn’t enough
right well GE wanted was 10 percent cost
reduction per year immediately after we
got those parts into production right so
how are you gonna do that again bring
the same team back together again let’s
understand how we can cost reduce those
pot up those products and years – and
years 3 right and so what we also knew
was that you can’t cost reduce a product
infinitely and so you can only cost
reduce for an iteration or maybe two and
then you’ve got to redesign that product
right for current functionality using
current manufacturing techniques current
design that’s available so you can’t
lean the rotary telephone into the
iPhone right and so you’ve got to start
over with a brand new technique and so
healthcare can learn from that process
right and that we’re constantly
iterating right and so I grew up in this
environment where costs came down
dramatically every year not one or two
percent but 10 to 30 percent and quality
increased dramatically every year and
that was the only experience that I knew
let’s compare that now to where we are
with
health care ok healthcare cost when I
joined the organization in 2007 cost
accounting was not standard and I would
tell you that even today Quast
accounting principles are now widely
used and because we don’t have cost
accounting we can’t understand the price
that it takes us to deliver a service to
the market at a reasonable profit and
establish that as our unit selling price
it’s just not feasible so in the absence
of that standard business process in
healthcare the government has stood in
and dictated the price for us so
Medicare establishes the price for all
medical services that are delivered
across the country and if you’re a
Medicare recipient you know exactly what
the price is going to be but here’s the
situation as soon as those Medicare
prices came out and the physicians and
the facility administrators looked at
what they had to deal with for
reimbursement many of them knew that
they could not make money on Medicare
alone as a payer and so they had to look
to other sources to sell their services
in order to have a viable business model
and so they looked to the insurance
companies and they look to the employers
and they negotiated rates with them
higher than Medicare and some of these
organizations were relatively modest at
the gains that they are that they were
able to get so maybe 20% over a Medicare
would be a modest increase for one of
these providers but others were maybe a
little bit more aggressive a bit a
little bit more nimble than their
negotiating technique and they may have
gotten as much as four times what
Medicare was willing to offer so here
you had a situation where the exact same
medical service delivered to patients if
you choose location a it’s roughly $1
choose location B roughly 4 bucks right
but this isn’t the only industry where
this this issue exists right so any of
you that have flown on an airplane
recently what you realize when you were
sitting in your middle seat and economy
something like this the price that you
paid for that seat was entirely
different from the price of the seed or
the fella just next to you right but you
were gonna leave at exactly the same
time
and you’re gonna get served the same
crummy snack in flight and you’re gonna
arrive at your destination at exactly
the same time and depart that airplane
right so it’s very similar service two
totally different prices but the
difference between the airline industry
and healthcare is that you could
actually shop for the lowest price in
the airline industry and sometimes
sometimes you can get it right but there
are things in in health care right that
preclude us from being able to buy from
the cheapest it’s it could be our
insurance policy right that doesn’t
allow us access to that lowest cost
provider or facility there’s also the
issue that we don’t pay for all of the
health care bill ourselves we only pay
for the first portion and the last piece
is paid by our employer and/or the
insurance company right so here you’re
gonna understand basically what the
health care system is up against and
what we’ve got to work with in terms of
a business model in healthcare ok so how
was it I came out of my manufacturing
space and got involved in healthcare
well back in 2007 there were a group of
doctors that decided they wanted to
deliver healthcare totally differently
and so they wanted to put together a
facility for bone muscle and joint care
and they created a building and in this
building they put their physician
offices and exam rooms but they also
added diagnostic testing so x-ray and
MRI scan and they had a surgery center
there as well to do operations on site
as well as physical therapy and even
thoughts so much to add a bracing
facility an orthotist and they created
what they thought they had in terms of a
much better delivery model a one-stop
shop but when I was introduced to that
and I saw what it was it felt to me more
like the medical mall right I still had
to do the shopping myself as a patient I
had to go from store front to store
front I had to deal with my own
appointments and calendar and
inefficiencies with that whole model but
I thought to myself what if
what if we could take that model and tip
it on its side and again think with the
end in mind and draw this process
forward in a aligned fashion and
actually manage the care of that patient
for them and give access to those
doctors on the same day that you wanted
to be seen and then have diagnostic
imaging there right away so that you
could be seen and have a proper
diagnosis rather than having to come
back for another visit and what if I
could get a treatment plan prepared
quicker than anybody else and then get
you back to where you were prior to your
injury and what if we compared that
entire spectrum of care to this
manufacturing thing that I talked about
this time to revenue and what if we call
that return to lifestyle and we were
able to prepare some value some true
value in the market that patients would
appreciate that employers would
appreciate it
so was with that prospect I stepped out
of manufacturing and joined this group
on this journey in healthcare and so for
the first time in my career I stood at a
crossroads the intersection of the
manufacturing world that I knew lined
with metrics and costs in rational
thinking in terms of pricing and this
world that I was about to know
healthcare with all of its ambiguities
and inefficiencies but the idea was can
you make a impact can you make a
difference by applying what you know to
what you think you can do and so far
here’s what I’ll tell you the results
are early on and they’re very limited in
scope but I feel really good about what
we’ve been able to accomplish and I
think it’s something that is repeatable
and scalable so let’s just take one
element right let’s pick on quality in a
surgical environment you want to make
sure you reduce infection you want to
keep infection out not only for cost
perspective but from a patient’s
perspective it’s a miserable experience
and so we wanted to pick on infection
right away and reduce that you know in
our environment but what do you choose
as the target well in the manufacturing
world that I came from we chose what was
called world class Six Sigma
three point four defects per million
opportunities very small but in the
surgery center we were only delivering
thousands of surgeries per year so it
was even smaller still so small in fact
that that number was approximately zero
and so that was our target our target
was zero we were gonna eliminate
infection from our operating rooms that
was our goal and so we had to fight
figure out a way to do this and so we
brought our medical team around the
table just like I had done previously
and figured out how to design a process
that was going to eliminate infection
from the operating rooms and so some of
the things were standard things that you
would consider normal taking care of the
facilities in the equipment to have
sterilization processes and protocols
that would eliminate that as being a
contributing factor and then we also
looked at Leave It or Not hand-washing
it’s one of the biggest contributors to
infection in an operating room the
protocol is to wash your hands and so we
made certain that not only did we have
them but we followed them we followed
them rigorously educating every one of
our staff members on the importance of
hand-washing when to wash your hands for
what duration with what product to
eliminate that as a contributing factor
but then we went a step further we asked
the ask experts of infectious disease
from the University of wisconsin-madison
to come in and take a look at our
processes and tell us what they thought
about where we were going and what they
said was this you’ve got another
significant contributing factor to
infection that you haven’t considered
and it’s you and me you see we as
patients we have bacteria on our skin
and if that bacteria is not cleaned
before surgery you can actually
introduce that bacteria into the
surgical wound and so what the industry
does is to give you an AI septic soap
and expect you to wash preoperatively to
reduce that opportunity but I can tell
you even in our processes our patients
were completely inconsistent in the way
that they used it so again thinking with
the end in mind drawing that education
process from late in a game to very
early in the game we told these patients
exactly what we wanted them to do in a
one-on-one education session and we said
here are the reasons why this is
important we want you to wash for this
duration of time at this period leave
the soap on this long
rinse at this time so we could reduce
the opportunity for infection but we
went a step further there as well we
told them why we said hey listen we have
created this team to reduce infection
and you are part of the team because
without your participation you could
introduce infection into this process
and you don’t want to become infected
right and so with this teamwork right
this way of working we’ve successfully
reduced the infection rates in our
operating rooms to three tenths of one
percent right versus the industry
average of one and a half percent so
five times less likely to become
infected in our operating rooms now
we’re not at zero so we’ve got a lot of
work yet to do but I can tell you this
if we hadn’t set our target at zero we
wouldn’t be where we are today right
next let’s pick on price so we’re we
have a price another industry that I can
assure you is one of the only industries
where you can have a service
administered to you and you have no idea
what the prices none and I’ll tell you
this not only do not know what upfront
what the price is going to be you don’t
know for five weeks after the service
right because you’re getting bills in
the mail I can tell you what we used to
do we’d send you a bill from the surgeon
the facility the anesthesiologist
physical therapy and the overnight stay
you didn’t know what to pay what not to
pay we thought we could do better so we
took our cost accounting team and our
business administration team and we
looked at these procedures alongside of
our medical staff and we said we can
predict what the cost of these
procedures should be the time in the o.r
who’s in the or how it should work and
we have our quality kind of figured out
we know what that’s going to be so we
should be able to give you a price one
price and one bill in the mail we
thought that was pretty good but then we
thought even better still what if I
could tell you prospectively
what that price was going to be what if
I told you well in advance what the cost
was going to be so you could shop it our
patients love this idea because now they
knew financially how to prepare for this
big expense okay and so I actually did
two things they reduced their it gave
them knowledge but also reduced their
anxiety right so there were less anxious
going into this procedure knowing that
we had thought about this
so those first two things I think are
pretty impactful in terms of business
application to healthcare the last one
I’ll tell you I am most proud of
absolutely most proud of because it is
the reason why people come back so our
patients have told us in survey after
survey and after we have a chance to
interview them we love the things that
you’ve done with cost we really
appreciate the quality but the reason I
would tell my friends and family to come
and see you the reason that I myself as
a patient would come back was because of
the way you made me feel that you
actually care that your doctors took the
time to listen to me and really
understood where I was and where I
wanted to be postoperatively and your
staff your staff genuinely authentically
wants to do the right thing and it
appears like they like their work like
they really like to be at work is that
true of all health care people different
right but here’s what happened when we
challenged these people right to very
extraordinary goals and they achieved
those goals it energized them it engaged
them in a way that I couldn’t have
predicted and that translated into a
patient experience that is absolutely
off the charts fantastic and I’m most
proud of that for sure so these are the
things that we can do now how can we
translate what we’ve done in a microcosm
here into something on a national scale
how does this reduce the cost of health
care overall well you and I again have
got to become consumers of health care
we’ve got to start asking in advance
what’s the price of this procedure and
with increasing intensity you’ll start
to get a response you’ve got to ask
things about quality what’s going on
with your infection rate your
readmission rate you see you have to act
like GE and juniper that were driving
our costs down and our quality up
there’s got to be a lever and we are it
right finally as providers we can do
more – we can continually improve our
processes on our own to increase
affordability and accessibility and we
need to do that we need to press on that
experience and I can tell you this if we
continue to thrive on our infection
rates to drive that number to zero and
no transparency today I don’t know what
my competitors rates are if I hit zero I
know they’re not lower than me
right
so let’s strive for perfection let’s see
if we can hit and what the results might
be if we were to hit it because I would
contend to you this if you’re striving
for perfection the competition becomes
inconsequential and we can absolutely
have a positive impact and not only the
cost but the experience and the quality
in health care thank you
you
when Warren Buffett addressed the
audience at his annual shareholders
meeting this year as a respected
business leader and thought leader the
audience expected to hear his take on
corporate tax reform and the benefits
afforded to his business as a result but
Buffett took the occasion to send an
entirely different message in truth he
said a Spectre far more sinister than
corporate taxes looms over corporate
American business and that issue is
health care cost nobody went on to say
was that health care costs are rising at
a rate so rapid right that they are
consuming the profits of corporate
businesses and he set it up this way
he says compare that the corporate tax
rates versus health care expenses over a
period of time and so we went back to
the 1960s and said corporate tax as a
percent of GDP or the value of the
economy was 4% in the 60s but today that
number is just 2% of the value of our
economy well keep that in perspective in
terms of the magnitude but let’s look at
health care cost over that same time
period 50 years ago healthcare costs
comprise just 5% of the value of the
economy overall today they comprise 17%
and growing there’s no end in sight
greater than three times approaching
four times what they were and so now you
can appreciate why Buffett and every
business leader and you and I should
also be so concerned about this cost now
a Buffett didn’t do is talk about the
ways that we can reduce cost but I can
assure you there are things that we can
do and we must do to reduce cost but
also improve quality and improve the
patient experience and we need only look
to other industries that have already
done this they’ve solved equally complex
problems with resources that are very
similar so where do I get the confidence
to say this why why do I have such
conviction well I came out of a
different space before healthcare I was
involved in manufacturing specifically
contract electronics manufacturing and
in that environment we had
stammers like General Electric and
Siemens and juniper Networks and these
customers were extremely demanding with
regard to product functionality but also
with regard to cost quality in the time
that we would deliver and so we
literally had to put a team of people
together to meet the demands of these
organizations so we had our design team
from product design as well as our test
engineers our manufacturing staff and
our procurement folks the folks that
bought the parts that were going to be
used all together around the table to
design these products to meet their need
and we got good at this right we got so
good at this in fact that we were known
for it so we’d take product out of
design get it through prototyping into
low value manufacturing high volume
manufacturing and making a profit or
revenue for our customers quicker than
anybody else and we’d call this process
time – revenue and we’d measure
ourselves based on our ability to get
product from design to revenue as
quickly as we could now we thought that
was pretty good and we felt good about
ourselves delivering that particular
service but our customers said that
wasn’t enough
right well GE wanted was 10 percent cost
reduction per year immediately after we
got those parts into production right so
how are you gonna do that again bring
the same team back together again let’s
understand how we can cost reduce those
pot up those products and years – and
years 3 right and so what we also knew
was that you can’t cost reduce a product
infinitely and so you can only cost
reduce for an iteration or maybe two and
then you’ve got to redesign that product
right for current functionality using
current manufacturing techniques current
design that’s available so you can’t
lean the rotary telephone into the
iPhone right and so you’ve got to start
over with a brand new technique and so
healthcare can learn from that process
right and that we’re constantly
iterating right and so I grew up in this
environment where costs came down
dramatically every year not one or two
percent but 10 to 30 percent and quality
increased dramatically every year and
that was the only experience that I knew
let’s compare that now to where we are
with
health care ok healthcare cost when I
joined the organization in 2007 cost
accounting was not standard and I would
tell you that even today Quast
accounting principles are now widely
used and because we don’t have cost
accounting we can’t understand the price
that it takes us to deliver a service to
the market at a reasonable profit and
establish that as our unit selling price
it’s just not feasible so in the absence
of that standard business process in
healthcare the government has stood in
and dictated the price for us so
Medicare establishes the price for all
medical services that are delivered
across the country and if you’re a
Medicare recipient you know exactly what
the price is going to be but here’s the
situation as soon as those Medicare
prices came out and the physicians and
the facility administrators looked at
what they had to deal with for
reimbursement many of them knew that
they could not make money on Medicare
alone as a payer and so they had to look
to other sources to sell their services
in order to have a viable business model
and so they looked to the insurance
companies and they look to the employers
and they negotiated rates with them
higher than Medicare and some of these
organizations were relatively modest at
the gains that they are that they were
able to get so maybe 20% over a Medicare
would be a modest increase for one of
these providers but others were maybe a
little bit more aggressive a bit a
little bit more nimble than their
negotiating technique and they may have
gotten as much as four times what
Medicare was willing to offer so here
you had a situation where the exact same
medical service delivered to patients if
you choose location a it’s roughly $1
choose location B roughly 4 bucks right
but this isn’t the only industry where
this this issue exists right so any of
you that have flown on an airplane
recently what you realize when you were
sitting in your middle seat and economy
something like this the price that you
paid for that seat was entirely
different from the price of the seed or
the fella just next to you right but you
were gonna leave at exactly the same
time
and you’re gonna get served the same
crummy snack in flight and you’re gonna
arrive at your destination at exactly
the same time and depart that airplane
right so it’s very similar service two
totally different prices but the
difference between the airline industry
and healthcare is that you could
actually shop for the lowest price in
the airline industry and sometimes
sometimes you can get it right but there
are things in in health care right that
preclude us from being able to buy from
the cheapest it’s it could be our
insurance policy right that doesn’t
allow us access to that lowest cost
provider or facility there’s also the
issue that we don’t pay for all of the
health care bill ourselves we only pay
for the first portion and the last piece
is paid by our employer and/or the
insurance company right so here you’re
gonna understand basically what the
health care system is up against and
what we’ve got to work with in terms of
a business model in healthcare ok so how
was it I came out of my manufacturing
space and got involved in healthcare
well back in 2007 there were a group of
doctors that decided they wanted to
deliver healthcare totally differently
and so they wanted to put together a
facility for bone muscle and joint care
and they created a building and in this
building they put their physician
offices and exam rooms but they also
added diagnostic testing so x-ray and
MRI scan and they had a surgery center
there as well to do operations on site
as well as physical therapy and even
thoughts so much to add a bracing
facility an orthotist and they created
what they thought they had in terms of a
much better delivery model a one-stop
shop but when I was introduced to that
and I saw what it was it felt to me more
like the medical mall right I still had
to do the shopping myself as a patient I
had to go from store front to store
front I had to deal with my own
appointments and calendar and
inefficiencies with that whole model but
I thought to myself what if
what if we could take that model and tip
it on its side and again think with the
end in mind and draw this process
forward in a aligned fashion and
actually manage the care of that patient
for them and give access to those
doctors on the same day that you wanted
to be seen and then have diagnostic
imaging there right away so that you
could be seen and have a proper
diagnosis rather than having to come
back for another visit and what if I
could get a treatment plan prepared
quicker than anybody else and then get
you back to where you were prior to your
injury and what if we compared that
entire spectrum of care to this
manufacturing thing that I talked about
this time to revenue and what if we call
that return to lifestyle and we were
able to prepare some value some true
value in the market that patients would
appreciate that employers would
appreciate it
so was with that prospect I stepped out
of manufacturing and joined this group
on this journey in healthcare and so for
the first time in my career I stood at a
crossroads the intersection of the
manufacturing world that I knew lined
with metrics and costs in rational
thinking in terms of pricing and this
world that I was about to know
healthcare with all of its ambiguities
and inefficiencies but the idea was can
you make a impact can you make a
difference by applying what you know to
what you think you can do and so far
here’s what I’ll tell you the results
are early on and they’re very limited in
scope but I feel really good about what
we’ve been able to accomplish and I
think it’s something that is repeatable
and scalable so let’s just take one
element right let’s pick on quality in a
surgical environment you want to make
sure you reduce infection you want to
keep infection out not only for cost
perspective but from a patient’s
perspective it’s a miserable experience
and so we wanted to pick on infection
right away and reduce that you know in
our environment but what do you choose
as the target well in the manufacturing
world that I came from we chose what was
called world class Six Sigma
three point four defects per million
opportunities very small but in the
surgery center we were only delivering
thousands of surgeries per year so it
was even smaller still so small in fact
that that number was approximately zero
and so that was our target our target
was zero we were gonna eliminate
infection from our operating rooms that
was our goal and so we had to fight
figure out a way to do this and so we
brought our medical team around the
table just like I had done previously
and figured out how to design a process
that was going to eliminate infection
from the operating rooms and so some of
the things were standard things that you
would consider normal taking care of the
facilities in the equipment to have
sterilization processes and protocols
that would eliminate that as being a
contributing factor and then we also
looked at Leave It or Not hand-washing
it’s one of the biggest contributors to
infection in an operating room the
protocol is to wash your hands and so we
made certain that not only did we have
them but we followed them we followed
them rigorously educating every one of
our staff members on the importance of
hand-washing when to wash your hands for
what duration with what product to
eliminate that as a contributing factor
but then we went a step further we asked
the ask experts of infectious disease
from the University of wisconsin-madison
to come in and take a look at our
processes and tell us what they thought
about where we were going and what they
said was this you’ve got another
significant contributing factor to
infection that you haven’t considered
and it’s you and me you see we as
patients we have bacteria on our skin
and if that bacteria is not cleaned
before surgery you can actually
introduce that bacteria into the
surgical wound and so what the industry
does is to give you an AI septic soap
and expect you to wash preoperatively to
reduce that opportunity but I can tell
you even in our processes our patients
were completely inconsistent in the way
that they used it so again thinking with
the end in mind drawing that education
process from late in a game to very
early in the game we told these patients
exactly what we wanted them to do in a
one-on-one education session and we said
here are the reasons why this is
important we want you to wash for this
duration of time at this period leave
the soap on this long
rinse at this time so we could reduce
the opportunity for infection but we
went a step further there as well we
told them why we said hey listen we have
created this team to reduce infection
and you are part of the team because
without your participation you could
introduce infection into this process
and you don’t want to become infected
right and so with this teamwork right
this way of working we’ve successfully
reduced the infection rates in our
operating rooms to three tenths of one
percent right versus the industry
average of one and a half percent so
five times less likely to become
infected in our operating rooms now
we’re not at zero so we’ve got a lot of
work yet to do but I can tell you this
if we hadn’t set our target at zero we
wouldn’t be where we are today right
next let’s pick on price so we’re we
have a price another industry that I can
assure you is one of the only industries
where you can have a service
administered to you and you have no idea
what the prices none and I’ll tell you
this not only do not know what upfront
what the price is going to be you don’t
know for five weeks after the service
right because you’re getting bills in
the mail I can tell you what we used to
do we’d send you a bill from the surgeon
the facility the anesthesiologist
physical therapy and the overnight stay
you didn’t know what to pay what not to
pay we thought we could do better so we
took our cost accounting team and our
business administration team and we
looked at these procedures alongside of
our medical staff and we said we can
predict what the cost of these
procedures should be the time in the o.r
who’s in the or how it should work and
we have our quality kind of figured out
we know what that’s going to be so we
should be able to give you a price one
price and one bill in the mail we
thought that was pretty good but then we
thought even better still what if I
could tell you prospectively
what that price was going to be what if
I told you well in advance what the cost
was going to be so you could shop it our
patients love this idea because now they
knew financially how to prepare for this
big expense okay and so I actually did
two things they reduced their it gave
them knowledge but also reduced their
anxiety right so there were less anxious
going into this procedure knowing that
we had thought about this
so those first two things I think are
pretty impactful in terms of business
application to healthcare the last one
I’ll tell you I am most proud of
absolutely most proud of because it is
the reason why people come back so our
patients have told us in survey after
survey and after we have a chance to
interview them we love the things that
you’ve done with cost we really
appreciate the quality but the reason I
would tell my friends and family to come
and see you the reason that I myself as
a patient would come back was because of
the way you made me feel that you
actually care that your doctors took the
time to listen to me and really
understood where I was and where I
wanted to be postoperatively and your
staff your staff genuinely authentically
wants to do the right thing and it
appears like they like their work like
they really like to be at work is that
true of all health care people different
right but here’s what happened when we
challenged these people right to very
extraordinary goals and they achieved
those goals it energized them it engaged
them in a way that I couldn’t have
predicted and that translated into a
patient experience that is absolutely
off the charts fantastic and I’m most
proud of that for sure so these are the
things that we can do now how can we
translate what we’ve done in a microcosm
here into something on a national scale
how does this reduce the cost of health
care overall well you and I again have
got to become consumers of health care
we’ve got to start asking in advance
what’s the price of this procedure and
with increasing intensity you’ll start
to get a response you’ve got to ask
things about quality what’s going on
with your infection rate your
readmission rate you see you have to act
like GE and juniper that were driving
our costs down and our quality up
there’s got to be a lever and we are it
right finally as providers we can do
more – we can continually improve our
processes on our own to increase
affordability and accessibility and we
need to do that we need to press on that
experience and I can tell you this if we
continue to thrive on our infection
rates to drive that number to zero and
no transparency today I don’t know what
my competitors rates are if I hit zero I
know they’re not lower than me
right
so let’s strive for perfection let’s see
if we can hit and what the results might
be if we were to hit it because I would
contend to you this if you’re striving
for perfection the competition becomes
inconsequential and we can absolutely
have a positive impact and not only the
cost but the experience and the quality
in health care thank you
you
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