4 Question Interview with Barbara Morales Burke

Another installment of the '4 Question Interview', this time with Barbara Morales Burke, Vice President of Health Policy, Blue Cross and Blue Shield of North Carolina. I posed the questions via email, and these are her answers, unedited by me. I appreciate her taking the time to answer the questions.

Question 1. What is the biggest problem facing the U.S. health care system?

The most pressing issue in our health care system is cost. Health care is simply unaffordable for many Americans. Any health reform effort that provides coverage to more people without addressing costs won’t work. Here’s the heart of the problem: we don’t get a good return in better health for the trillions of dollars we spend on health care. Our current system is geared toward treating illnesses and performing procedures. It does not do such a good job at helping people stay well.

To lower costs, reform should do three things:

Improve the quality and effectiveness of care. At BCBSNC, we’ve created Centers of Excellence for cancer care, heart surgery and obesity surgery to encourage hospitals and physicians to adopt nationally accepted quality standards. Our aim is to reward doctors and hospitals based on their demonstrated expertise, improve patients’ health outcomes and reduce the incidence and cost of medical complications. We’ve also partnered with North Carolina hospitals to improve safety and reduce avoidable medical errors.

Promote preventive care and lifestyle changes.

Provide better care to patients, not more care. We believe health care providers should be rewarded for what they do to help patients improve or maintain their health, not just for the number of procedures they perform.

Question 2. What do you most want to see preserved about the U.S. health care system?

Our system now provides consumers a choice in doctors, hospitals and other health care providers. We believe consumers will continue to demand that kind of choice. Choice needs to be preserved.

We believe that employer-based health insurance, which serves more than 160 million Americans today, should be strengthened as a primary means of health coverage. For those who do not have coverage through their work, we support reforms to help them get access to the care that they need.

By building on what works today, we believe we can achieve a system that covers all Americans, promotes health, and uses financial resources effectively.

Question 3. What is the most important health policy priority for North Carolina (or the USA)? [answer which ever you want to answer]

The immediate priority is to get everyone covered. Americans should be required to be insured, and the government should help those who can’t afford their premiums. With everyone in the insurance pool, the system can work the way it was intended to - with medical costs spread across both the healthy and the sick. We must do this is in a way that promotes affordability in general, being careful that we do not overly burden healthy people with higher premiums as we work to cover those who have difficulty affording premiums currently because of their health circumstances. We are also concerned about some proposed taxes and fees on health plans and benefits that would serve to make coverage more expensive.

The longer-term priority is to foster a culture that promotes healthy lifestyles. That’s a priority no matter what health reform legislation Congress passes. Without a focus on health promotion, we will be dealing with the same problems – or worse – in the coming decades.

Question 4. If you could design a health system from scratch, what would it look like?

That’s a great question. We want a system in which consumers can chose from a variety of health care plans, without regard to their health circumstances or financial condition. All Americans should be required to get coverage, with the government providing assistance to those who can’t afford their premiums.

We believe in a system in which patients get the right care at the right time, from skilled providers using the best medical evidence available. Doctors, hospitals and other health care providers should be rewarded financially for their expertise and for their patients’ health outcomes. The system would expand the collaboration already going on between doctors, hospitals and insurers to reduce costs and provide better care. We want to see technology used as effectively as possible to help providers collaborate to improve the health of their patients and to help consumers choose quality health plans, providers and treatments.