Shortly before 2016's historic presidential election, the Nashville Health Care Council invited some of the country's most knowledgeable health policy leaders to the nation's healthcare capital to discuss the future of the industry.
Former Senate Majority Leader Bill Frist, MD, a partner at Cressey & Company, welcomed guests to Nashville and moderated the conversation. Featured panelists were Former Senate Majority Leader Tom Daschle, founder and CEO, The Daschle Group; Former Governor Mike Leavitt, founder and chairman, Leavitt Partners; and former White House Deputy Chief of Staff for Policy Nancy-Ann DeParle, partner, Consonance Capital.
Frist set the stage by briefly reviewing both parties' stances with regard to healthcare policy. "The Democrats' position is to build on the Affordable Care Act, with Clinton committing to work with the 19 states that have yet to expand Medicaid, encouraging them to get on board. At the same time, the Republican platform emphasizes a 'repeal and replace' stance, promoting more state engagement, private sector solutions and alternatives," he explained.
The panelists discussed a range of topics, including top priorities for the president-elect, Medicaid expansion, the healthcare exchange and predictions on the future of healthcare policy under a Clinton or Trump presidency.
"There is no question; progress has been made with regard to access since the Affordable Care Act was implemented. But, we never expected it to happen overnight. The goal of the ACA was not only to cover the uninsured - it was also to change the system, and we're seeing that through the move to value-based payments and lower healthcare costs," said DeParle, who spearheaded President Obama's successful effort to enact the ACA and managed the initial implementation of the law.
Daschle, who graciously agreed to dive deeper into the subject with Nashville Medical News (Q&A with Sen. Tom Daschle), noted, "With regard to Medicaid expansion, it's important to remember that it took 17 years to implement Medicaid in all states when the program began, so it will take time. If we can create flexibility, addressing the specific needs of each state and allowing each state to create its own implementation plan, we will see more expansion."
Leavitt offered a unique perspective from his experience. "The obstacle to expanding Medicaid sits not with the governors, but with the state legislatures. In some ways, the federal government is tying the hands of those who administer Medicaid at the state level. If those in D.C. set the standards and let states create their own systems, in many cases, it would work much better," he said. "The key for states is to be able to expand in a way that reflects their own population and values."
Overall, the group agreed that there is some potential for bipartisan cooperation under a new administration after nearly eight years of congressional gridlock.
"The two most transformative factors in healthcare have been technology and policy. Technology has changed everything, and we're only beginning to grasp its potential. But policy is not keeping up," said Daschle. "We need to remove policy barriers to things like research, interoperability and telemedicine, if we want to move forward on innovation and improve the healthcare system. This is an area that can see bipartisan support."
The panelists also emphasized the caliber of talent within Nashville's healthcare community, and the importance of voicing this expertise in Washington.
"The government is not great at innovating, but they are good at getting behind innovation. Your job is to continue to innovate, keep a dialogue with those in Washington and oppose regulations that can hinder progress," said Leavitt.
"The Council convenes the most knowledgeable and innovative minds in healthcare," DeParle added. "Bringing leaders from D.C. to Nashville to speak with this group is very important as we create the future of healthcare. It is equally important for the experts in this room to visit policymakers in D.C. and make your voices heard."
