Miller/UHealth VP Donelan Discusses Health Reform with Students

The American health care system is a “unique conundrum” that developed over many decades, with many agendas and with some extremely well-functioning segments. But it’s “not the kind of system you would put in place if you were starting over today.”

So said William Donelan, health care strategy czar for the Miller School and University of Miami Health System – UHealth, who, in speaking to medical students on Wednesday, drew on his keen understanding of health care policy, delivery, costs and government reform gleaned from his long career in academic-based medicine. Before joining UM in September 2006, Donelan spent 36 years at Duke University, including seven years as the executive vice president and vice chancellor for health affairs.

“There is an insidious effect on our health care system,” said Donelan, UHealth vice president for medical administration and chief operating and strategy officer. “Because there are so many uninsured, health systems factor the cost of treating those who can’t afford to pay for care into the health system’s price structure, which includes paying for the working poor who don’t have access to benefits.

“But the rate of increase for these costs year-over-year is unsustainable. Soon enough, the system will get broken enough where we have to fix it,” Donelan added, explaining that the health care reform bill President Obama pushed through Congress was a serious attempt to repair the system, even though newly elected lawmakers vow to repeal it.

Still, Donelan said, the current law contains several “fundamentals” that are attractive to health care providers. It also includes provisions for reducing costs and unnecessary repetitive procedures, maintaining wellness and emphasizing accessible electronic medical records, such as the EPIC system being used by UHealth for its UChart electronic medical records initiative.

Donelan spoke at the third installment of the Health Reform Lecture Series, a forum students designed for open discussions on the implications of the health care reforms for the U.S. health care system, and how they will directly affect them – the future providers of health care.

“The health reform package recently passed by Congress amounts to the largest expansion of our health care system since Medicare,” said Arash Harzand, a fourth-year M.D./M.B.A. student who directs the lecture series and is president of the Miller School’s Business of Medicine student group. “As tomorrow’s physicians, it’s vital that we understand these changes as they develop and become integrated in order for us to provide the best care to our patients in the future.”

The U.M. Ethics Programs sponsor the lecture series. Wednesday’s event was preceded by discussions led by Eric Kriss, former secretary of finance and administration for Massachusetts under Gov. Mitt Romney, and a key player in the passage of that state’s so-called “Romneycare,” and Steven Ullmann, Ph.D., professor of management and economics at the UM School of Business and director of the school’s Programs in Health Sector Management and Policy.

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