Health Care Reform - Full Article

By John Mackey, August 14, 2009  |  Meet the Blogger  |  More Posts by John Mackey

As you are probably aware, I wrote an Op/Ed piece that was published in the Wall Street Journal earlier this week on health care reform, one of the biggest and most emotional issues facing our country. I was asked to write an Op/Ed piece and I gave my personal opinions. While I am in favor of health care reform, Whole Foods Market as a company has no official position on the issue.

 

In answer to President Obama's invitation to all Americans to put forward constructive ideas for reforming our health care system, I wrote this Op/Ed piece called simply "Health Care Reform." An editor at the Journal rewrote the headline to call it "Whole Foods Alternative to Obamacare," which led to antagonistic feelings by many. That was not my intention - in fact, I do not mention the President at all in this piece.

 

I fully realize that there are many opinions on the healthcare debate, including inside my own company. As we, as a nation, continue to discuss this, I am hopeful that both sides can do so in a civil manner that will lead to positive change for all concerned. You are welcome to share your thoughts in the comments section below. (Just remember our comment guidelines prohibit vulgarity and personal attacks.)

 

Here is the original unedited version that I submitted.

 

Health Care Reform

 

"The problem with socialism is that eventually you run out of other people's money" —Margaret Thatcher.

 

With a projected $1.8 trillion deficit for 2009, several trillions more in deficits projected over the next decade, and with both Medicare and Social Security entitlement spending about to ratchet up several notches over the next 15 years as Baby Boomers become eligible for both, we are rapidly running out of other people's money. These deficits are simply not sustainable and they are either going to result in unprecedented new taxes and inflation or they will bankrupt us.

 

While we clearly need health care reform, the last thing our country needs is a massive new health care entitlement that will create hundreds of billions of dollars of new unfunded deficits and moves us much closer to a complete governmental takeover of our health care system. Instead, we should be trying to achieve reforms by moving in the exact opposite direction-toward less governmental control and more individual empowerment. Here are eight reforms that would greatly lower the cost of health care for everyone:

 

1. Remove the legal obstacles which slow the creation of high deductible health insurance plans and Health Savings Accounts. The combination of high deductible health insurance and Health Savings Accounts is one solution that could solve many of our health care problems. For example, Whole Foods Market pays 100% of the premiums for all our team members who work 30 hours or more per week (about 89% of all team members) for our high deductible health insurance plan, and provides up to $1,800 per year in additional health care dollars through deposits into their own Personal Wellness Accounts to spend as they choose on their own health and wellness. Money not spent in one year rolls over to the next and grows over time. Our team members therefore spend their own health care dollars until the annual deductible is covered (about $2,500) and the insurance plan kicks in. This creates incentives to spend the first $2,500 more carefully. Our plan's costs are much lower than typical health insurance, while providing a very high degree of team member satisfaction.

 

2. Change the tax laws so that that employer-provided health insurance and individually owned health insurance have exactly the same tax benefits. Right now employer health insurance benefits are fully tax deductible for employers but private health insurance is not. This is unfair.

 

3. Repeal all state laws which prevent insurance companies from competing across state lines. We should all have the legal right to purchase health insurance from any insurance company in any state and we should be able use that health insurance wherever we live. Health insurance should be portable everywhere.

 

4. Repeal all government mandates regarding what insurance companies must cover. These mandates have increased the cost of health insurance many billions of dollars. What is insured and what is not insured should be determined by individual health insurance customer preferences and not through special interest lobbying.

 

5. Enact tort reform to end the ruinous lawsuits that force doctors into paying insurance costs of hundreds of thousands of dollars per year. These costs are ultimately being passed back to us through much higher prices for health care.

 

6. Make health care costs transparent so that consumers will understand what health care treatments cost. How many people know what their last doctor's visit cost? What other goods or services do we as consumers buy without knowing how much they will cost us? We need a system where people can compare and contrast costs and services.

 

7. Enact Medicare reform: we need to face up to the actuarial fact that Medicare is heading towards bankruptcy and move towards greater patient empowerment and responsibility.

 

8. Permit individuals to make voluntary tax deductible donations on their IRS tax forms to help the millions of people who have no insurance and aren't covered by Medicare, Medicaid, SCHIP or any other government program.

 

Many promoters of health care reform believe that people have an intrinsic ethical right to health care-to universal and equal access to doctors, medicines, and hospitals. While all of us can empathize with those who are sick, how can we say that all people have any more of an intrinsic right to health care than they have an intrinsic right to food, clothing, owning their own homes, a car or a personal computer? Health care is a service which we all need at some point in our lives, but just like food, clothing, and shelter it is best provided through voluntary and mutually-beneficial market exchanges rather than through government mandates. A careful reading of both The Declaration of Independence and the Constitution will not reveal any intrinsic right to health care, food or shelter, because there isn't any. This "right" has never existed in America.

 

Even in countries such as Canada and the U.K., there is no intrinsic right to health care. Rather, citizens in these countries are told by governmental bureaucrats what health care treatments and medicines they are eligible to receive and when they can receive them. All countries with socialized medicine ration health care by forcing their citizens to wait in lines to receive scarce and expensive treatments. Although Canada has a population smaller than California, 830,000 Canadians are waiting to be admitted to a hospital or to get treatment. In England, the waiting list is 1.8 million citizens. At Whole Foods we allow our team members to vote on what benefits they most want the company to fund on their behalf. Our Canadian and British team members express their benefit preferences very clearly-they want supplemental health care more than additional paid time off, larger donations to their retirement plans, or greater food discounts; they want health care dollars that they can control and spend themselves without permission from their governments. Why would they want such additional health care benefit dollars to spend if they already have an "intrinsic right to health care"? The answer is clear: no such right truly exists in either Canada or the U.K. or in any other country.

 

Rather than increase governmental spending and control, what we need to do is address the root causes of disease and poor health. This begins with the realization that every American adult is responsible for their own health. Unfortunately many of our health care problems are self-inflicted with over 2/3 of Americans now overweight and 1/3 obese. Most of the diseases which are both killing us and making health care so expensive-heart disease, cancer, stroke, diabetes, and obesity, which account for about 70% of all health care spending, are mostly preventable through proper diet, exercise, not smoking, minimal or no alcohol consumption, and other healthy lifestyle choices.

American Diet

Over the past two decades, breakthrough scientific research by Colin Campbell, as documented in his book The China Study, and clinical medical experiences by many doctors including Dean Ornish, Caldwell Esselstyn, John McDougall, Joel Fuhrman, and Neal Barnard have shown that a diet consisting of whole foods which are plant-based, nutrient dense, and low-fat will help prevent and often reverse most of the degenerative diseases that are killing us, and becoming more and more expensive to treat through drugs and surgery. We should be able to live healthy and largely disease free lives until we are well into our 90's and even past 100 years of age.

 

Health care reform in America is very important. Whatever reforms are enacted it is essential that they be financially responsible and that we have the freedom to choose our own doctors and the health care services that best suit our own unique set of lifestyle choices. We are responsible for our own lives and our own health. We should take that responsibility very seriously and use our freedom to make wise lifestyle choices that will protect our health. Doing so will enrich our personal lives and will help create a vibrant and sustainable American society.

Category: health care reform

 

4,664 Comments

Comments

Scott Hawkins - Anchorage AK says ...
<p>John ' loved your interview in the WSJ this weekend. And admire your straightforward honesty and practical approach to health care. Please don't let the political thought police put you on the defensive.</p> <p>By the way, we could really use a WF in Anchorage, Alaska. I believe it would be a big hit!</p>
10/04/2009 3:18:00 PM CDT
Richard says ...
<p>Mr. Mackey, have you ever tried to shop around for your health care services to save money? This is next to impossible. Doctors themselves do not know the cost of the tests, procedures and drugs they order, although many have conflicts of interest and a financial interest in over subscribing. And the large hospital systems, where most the most expensive care takes place, are grossly inefficient and have no effective competition. Once your doctor has steered you in, there is no shopping around to be had, The costs are what they are, and you have zero to say about it. I believe we have to start with an end to fee for service, and also ending the monopolistic, non competitive nature of the large hospital systems.</p>
10/04/2009 4:31:00 PM CDT
sara says ...
<p>Let them eat organic cake, right, Mr. Mackey?<br> Everyone deserves healthcare.</p>
10/04/2009 4:54:00 PM CDT
Kerri Wood says ...
<p>Dear Mr. Mackey:<br> I just got a piece of mail from HealthCareForAmericaNow.org (I have no idea how I got on their mailing list). I was interested in what you had to say in your op/ed. I agree with most of your thoughts. What happened to a free exchange of ideas in our country. I am grateful that you have taken a stand while so many do nothing. THANK YOU!<br> Kerri Wood</p>
10/04/2009 10:48:00 PM CDT
whole foodie says ...
<p>john mackey does not care about poor people (in america).</p> <p>john mackey does not understand the constitution. the constitution does not sy\ay anything about public education, but we dig it. nor does it say anything about clean water out the tap, but we think that is a right as well. so why can't we have health care even though it is not mentioned in the constitution?</p>
10/04/2009 11:27:00 PM CDT
Karen Desjardin says ...
<p>Just read the article 'The Conscience of a Capitalist' in today's WSJ Europe edition and I was so positively impressed by your thoughts on health care reform that I searched on the internet for some way of contacting you. Somehow I missed your op-ed piece in the WSJ, and as an American currently living in Switzerland, I also missed the news of boycotts and 'buycotts' regarding Whole Foods stores. I want to thank you for writing the piece and for offering excellent, constructive suggestions for health care reform. In particular, I think the idea of repealing all state laws which prevent insurance companies from competing across state lines is an excellent idea as is your suggestion for tort reform. These are things that could help bring about some real cost effective changes. I also have to agree with something I read in the WSJ interview with you. I, too, think it's a shame that so few elected officials have ever run a business. This is the first time I have ever written a comment on a blog, so that should give you an idea of how much I appreciate your writing of the op-ed piece and your views on health care reform. I respect your word that these are your opinions and not the official opinion of Whole Foods. I just wish those that have encouraged the boycotts would have more respect for the honest public discourse that we need to have on this important issue. I am really disappointed anyone would organize a boycott of your stores for this. That's why I will continue to shop at Whole Foods, in fact, go out of my way to shop at Whole Foods, whenever I return to the US.</p>
10/05/2009 3:45:00 AM CDT
Nick Fishman says ...
<p>I didn't catch your Op-Ed in the Journal back in August, however I read your 'Weekend Interview' on Saturday and couldn't agree more with your approach to the healthcare debate. Before we start looking to the government for intervention, both businesses and individuals must take some responsibility. Individuals have to start by taking care of themselves. They have to start eating right, exercising, stop smoking, etc. As Whole Foods has demonstrated, businesses have to get creative with their approach as well. Yes, there is a serious problem with our healthcare system, but everyone seems to be ignoring these most fundamental issues.</p>
10/05/2009 8:37:00 AM CDT
Dick Dotson says ...
<p>Dear Mr Mackey ' I very much agree with your op-ed in the Wall Street Journal and, even more on your interview with Stephen Moore in last Saturday's issue.</p> <p>My wife (Nancy) and I lived in Houston from 1969 to 1978 and were well acquainted with Rod and Page (since of deceased)Lawson. We also know their daughter, Renee, one of the originators of Whole Foods. We have stayed in touch with Rod even though we strongly disagee politically. We sent the op-ed piece to Rod and intend to send the interview mentioned above. I do not know if it will have any effect but felt he should be aware of the 'common sense' approach you take as I think admires your accomplishments.</p> <p>I admire your speaking at colleges and universities as they need the type of political philosophy you espouse, particularly since most of the students receive a heavy dose of liberalism from their professors. I hope you will continue this plus continuing in other ways to speak out. Perhaps there is some politician(s) in Texas to work with that feels 'business is not evil'. We feel this administration is headed directly for socialism and our way of life is severely threatened. The more focus the public hears from you and your ideas, the more chance we can avert the direction the administration is trying to take us. We must try to save our country and we greatly appreciate your efforts.</p> <p>Thank you</p> <p>Dick Dotson</p>
10/05/2009 10:27:00 AM CDT
Erin Rezac says ...
<p>Thank you Mr. Mackey for the great article ' you hit the nail on the head that Americans need to start being more responsible when it comes to their health by eating a whole foods plant based diet. I recently read The China Study and thought it was amazing. Thanks for all that you do to make the world a better place! If only more CEOs and government officials thought the way you do. Sincerely, Erin Rezac</p>
10/05/2009 12:17:00 PM CDT
Tina says ...
<p>Mr. Mackey,<br> I have been a fan of Whole Foods Market for a long time. However, I will be taking my business elsewhere. I am fortunate I can afford to shop at stores like yours and afford healthcare. However, I also see the needs of many who are not so fortunate. Your analysis is overly simple and demeaning to many. And therefore, I will take my business and many others with me to your competitors. I truly hope that you never have to discover first hand why your views are short sighted.</p>
10/05/2009 4:25:00 PM CDT
Courtney says ...
<p>Agree with the 'Can we clone you, Mr. Mackey' statement! <img src="The%20CEO%E2%80%99s%20Blog%20%C2%BB%20Blog%20Archive%20%C2%BB%20Health%20Care%20Reform%20%E2%80%93%20Full%20Article_files/icon_smile.gif" alt=":)" class="wp-smiley"> What a great article!! Finally a common sense approach to this matter. </p> <p>Please please please make some sort of movie (ala Al Gore) and spread your message to the masses.</p>
10/05/2009 4:38:00 PM CDT
Kent Jackson says ...
<p>Mr. Mackey,</p> <p>Your WSJ article is one BIG reason I shop at Whole Foods. Before I understood, I used to complain mostly to myself about your 'high' prices until about a year ago when I found that I was spending less on food, feeling better, and was healthier! Who would have thought that? Notice that even while I was complaining I still shopped at Whole Foods <img src="The%20CEO%E2%80%99s%20Blog%20%C2%BB%20Blog%20Archive%20%C2%BB%20Health%20Care%20Reform%20%E2%80%93%20Full%20Article_files/icon_smile.gif" alt=":-)" class="wp-smiley"></p> <p>Do not let the looters deter you and your company you have many people who speak for you everyday. The true measure of respect between individuals is the willingness to give a tangible expression (money) of one life's work to another in the form of an honorable exchange. </p> <p>I like my local Whole Foods store the people who work there understand REAL money is being handed to them, earned, not looted'¦</p> <p>Thank you for your time,</p> <p>Kent</p>
10/05/2009 6:16:00 PM CDT
Brian Wechsler says ...
<p>John Mackey offers a compelling proposal, based on his practical experience implementing healthcare benefits at a major corporation, unlike most pundits on either side of this debate. Whole Foods and Safeway have both implemented progressive and effective plans which show that health care reform without major government control is not only possible but achievable. If this hulabaloo by Team Obama and leaders in Congress is really an honest effort to improve health care, HR 3400 should be a major part of the debate. It includes much of what John wrote about and is a serious effort to provide major reform without massive deficits and the government take over of nearly 20% of our economy.</p>
10/05/2009 8:33:00 PM CDT
Aaron Gillespie says ...
<p>Mr. Mackey, Just wanted to add my thanks and let you know I appreciate your article. I read the WSJ one when it came out and today I was looking for some more 'fresh ideas' and decided to stop by your blog and found the 'original article' I like it better then the edited version.</p> <p>Information is the currency of democracy.<br> Thomas Jefferson</p> <p>Thanks for shareing</p>
10/05/2009 9:49:00 PM CDT
Saidah Blount says ...
<p>I am disappointed and dismayed at the comments from the CEO of Whole Foods. Health care is an intrinsic right, not a perk for the wealthy. Mr. Mackey lost my respect from the get-go by trying to link fair and equal treatment for all citizens of this nation to socialism in his op/ed's intro'¦ for shame.</p> <p>Please note that over 100,000+ people have signed on to boycott Whole Foods (to date'¦ and may it grow and grow), and my family and I will be joining them. I will also encourage all of my friends and anyone else that I will discuss the healthcare issue to join this important boycott as well.</p>
10/05/2009 10:56:00 PM CDT
Ben Dawson says ...
<p>Mr. Mackey,</p> <p>Needless to say, you have received many comments about your blog on health care. I am an economics major at Baylor University and our business professor tagged your WSJ article for us to read. I wholeheartedly agree with your support of the free markets and capitalism in general. I have heard that you travel to colleges speaking to students about business and the good it brings. I am a leader of the Baylor Young Conservatives of Texas and am in charge of the speakers that we invite to speak. I, along with the rest of the organization, would be deeply honored if you came to Baylor to speak. Whole Foods has a great business model and your conservative ideals are to be admired. You have my email address and can contact me whenever you find time. Hope to hear from you!</p> <p>Ben Dawson</p>
10/06/2009 2:55:00 AM CDT
JB says ...
<p>Mr. Mackey, </p> <p>As a Whole Foods shareholder and once loyal customer, I frequently cringe at the things you say and do. I respect your free speech rights fully, even if I passionately disagree with your arguments. But your 'ObamaCare' WSJ article was the last straw. As of today, I will no longer be a shareholder and will boycott your store. I also will urge the many others I know who share my sentiments to do the same. I think if you got to know your customers a little better, you'd realize that a large percentage of us support the president and his policies. </p> <p>Best of luck,</p> <p>JB</p>
10/06/2009 12:45:00 PM CDT
greg desanto MD says ...
<p>Mr. Mackey,</p> <p>Your ideas are refreshing and very much on point, espousing personal responsibility in this healthcare debate. I would like to present a letter I sent to our Senators in Arizona about the medical communities responsibility to have price transparency in everything we do, so that the costs of healthcare can be exposed, and eventually reduced. Please take the time to read this letter carefully.</p> <p>GDeSanto, M.D.</p> <p>Senator John Kyl<br> 730 Hart Senate Office Building,<br> Washington, DC 20510 </p> <p>Dear Senator Kyl:</p> <p>I am writing this letter out of exasperation over the present healthcare debate going on in Washington. After finally putting these thoughts on paper, this may in retrospect be the very most important letter that I have ever written. I am sending a copy of this letter to Senators and Congressman that I hope can shape this discussion and help the healthcare system evolve by returning to very basic free market economic principles that have made our country the envy of the world. </p> <p>I am an obstetrician/gynecologist, practicing in Scottsdale, Arizona for the past 20 years. I have seen the healthcare industry up close through my years in practice and my interactions with the insurance industry have enlightened me to the stark realities of a medical insurance industry that has little or no interest in advocating for their customers, due to perverse economic incentives. </p> <p>While I live and practice in an affluent community and could easily play along with the status-quo for the remainder of my career, I see people each and every day that face the insurance system and are unfairly treated because of insurance gimmicks or because they simply cannot afford insurance anymore. There isn't a day that goes by even in my practice where I find myself advocating for a patient on the potential or realized costs of healthcare.</p> <p>I would like to finish by career working on behalf of my patients in medical system that works from a very basic premise: each and every person should be offered the same cost for care and it is our moral responsibility as healthcare providers to work to keep the cost of our care reasonable. The fact that a family of four now must pay over $800 a month and still come out of pocket for the 1st two or three thousand dollars of care is for most families untenable.</p> <p>About 6 months ago, two broadcasts caught my attention, and brought me to thinking how far down the wrong road healthcare has gone in relating to the general public and it's perception of costs.</p> <p>My wife asked me to watch an Oprah Winfrey episode discussing nationalizing healthcare. Michael Moore, the film producer, a representative from the health insurance industry, and a former medical director from an insurance plan who rightly regrets now using her medical degree to deny care, were on the show. A family member from a patient who had died from leukemia had explained that could not raise the $150,000 needed fast enough for him to receive chemotherapy, because he did not have insurance. This is certainly a tragedy and Michael Moore was espousing that in Canada this would not have happened. He is probably right, but there would have been a large line in and impersonal care facing this patient. I found myself screaming at the TV. Why wasn' t anyone asking why it costs $150,000 for the chemotherapy?</p> <p>I am struck by the fact that no one ever asks the hard but very obvious question, why do certain procedures or treatments in healthcare cost so much?</p> <p>Chemotherapy for leukemia shouldn't cost one-fifth, maybe even one-tenth of $150,000 in a perfect world where costs were transparent. I am sure there would be entrepreneurs that could drive the costs down, based on volume and hard negotiations with the drug manufacturers Costs of highly technical services could be much lower if the incentives were aligned, still with an emphasis on quality. The key is to let the consumer choose where to go, based both on cost and quality.</p> <p>John McCain, our senator here in Arizona, was similarly on a morning news show during the election and was asked the question of what could be done about high health care costs. He stated very correctly that it never seemed to amaze him about the innovation and brilliance of medicine in our country. He then posed the question why, after the innovation, doesn't the cost come down? He was on to the answer, but never completed the thought. I again screamed at the TV.</p> <p>The answer to this dilemma lies in commoditizing much of what we do in medicine.</p> <p>The very simple answer to John McCain's question is to pass a law tomorrow that requires every healthcare provider in America to publish their prices for their services.</p> <p>This includes doctors, dentists, veterinarians, hospitals, nursing homes, pharmacies, drug manufacturers, high tech medical equipment makers and everyone else remotely connected to healthcare. At this point, American's can begin choosing their care and comparing care based on both quality and price.</p> <p>This will upset many entrenched groups, particularly the insurers and those niches in medicine, particularly those in academic medical centers that are relatively well protected. However, with transparency, access could open up to healthcare for new millions of patients, without the high risks of rationing. Medicine can be a growth industry without driving the costs of individual care up. By beginning to commoditize what we do, the costs should come down as resources are reassigned to the point of care.</p> <p>In Silicon Valley and in the high tech industries, a new idea or product has an upfront expense to development and an associated high cost to purchase initially, but eventually the costs come down as the dreaded word 'commoditize' comes to bear and others enter the field. Commoditizing in high tech frequently involves continued improvement, despite lower prices. Good examples are flat panel TVs, computers or cell phones. This doesn't seem to happen in medicine, all because the costs are so mysterious.</p> <p>Wal-Mart began a generic prescription program about 4 years ago that has revolutionized the pharmacy community. They created a $4 prescription program for 30 day supplies of hundreds of commonly used medications that was eventually matched by Target and later most of the large pharmacy chains. A very good birth control pill, the generic form of Ortho-cyclen and Tricyclen was offered at $8 per pack, a dramatic savings over the standard $20 generic or $50 brand name.</p> <p>Suddenly, the brand name manufacturers had to compete against the Walmart/Target generic and the costs of most birth control pills is dropping. Granted, there seems to be fewer new pills and certainly fewer free lunches to detail pills, but patients are benefiting greatly. Certainly, senior citizens have benefited with the generic programs and most primary care doctors now look to these lists first, in order to save their patients money. </p> <p>Those in the retail pharmaceutical industry will tell you that this has fundamentally and not so quietly changed their industry. The health of patients has not suffered and in fact has significantly benefited with improved compliance. Costs to patients have dramatically dropped. This free market example of the generic competition is an important example of what is possible in medicine.</p> <p>Doctors and hospitals are in great degree responsible for the perception of the extreme costs of medicine that perpetuates a vicious cycle of extraordinary bills (the term 'magical' is very appropriate) that are eventually negotiated down by the insurers to 30 or 40 cents on the dollar. In the interim, each of us continue to buy unnecessarily expensive insurance to avoid a bill that no one can understand but threatens to bankrupt us. The insurance companies hold all the cards and get to control even the first dollar of everyone's healthcare.</p> <p>I would envision a day where centers of excellence develop for more complex care, based on price and quality to do procedures better and more efficiently. Patients may have to travel for their procedure, but will receive the highest quality care at the most efficient price. There would finally be incentives to do a procedure on time, on budget and with the lowest likelihood of complications. The incentives would all be aligned and at end of the day, we would be serving everyone equally.</p> <p>Simpler procedures done in doctor's, dentist's offices, and hospitals similarly should have transparency in cost. Certainly, many patients would not opt for the lowest priced surgeon or even dentist, but ranges in pricing would motivate doctors to be aware of others pricing and look to achieve efficiencies in their procedures many times by negotiating their costs from suppliers, ancillary medical personnel and hospitals.</p> <p>I would also envision $85 dollar mammograms and eventually $50 or $60 mammograms that are set up in convenient locations that everyone could afford, if left to smart businessmen. $100 annual physicals with complete blood work and an annual report to the patient with goals for the coming year would be the norm. Complete packages for commonly done procedures including all doctor and hospital fees should be open for everyone to see. Prices for chemotherapy and other high cost treatments should be outlined in detail, enabling patients and their families to shop for the most efficient treatments, based on their doctors advise.</p> <p>We all know up front what it costs to buy our groceries or consumer staples. We pay up front and receive a competitive price. All of us tomorrow would like to know the up front costs for a dental procedure or a teeth cleaning. Why not at least ask what it costs to take out your gall bladder or tonsils?</p> <p>Certainly most patients even now don't know that ibuprofen is equivalent to Motrin at half the cost. How might you ask are they going to pick a quality doctor for highly technical cancer surgery, or to remove their bunion? In the age of the Internet, I am quite certain websites can be developed to assess price and quality, comparing doctors throughout the country or even the world. This is where government could serve an honorable purpose, by providing guidance in helping patients shop for care and avoiding unethical doctors and clinics with unproven treatments.</p> <p>In hospitals, I specifically think that the only way we are going to get a handle on our national health care costs is by opening up all their costs and charges for inspection by the consumer and allowing more consumer choice based both on quality and price. There is enormous waste and extreme overhead in hospitals that needs to identified and eliminated in order to deliver more care to more people for less. </p> <p>I am so proud to be associated with hospitals that treat each and every patient the same when the come in the front door, but I am similarly embarrassed to find out those without insurance or poor insurance are treated so poorly by the billing departments after they leave.</p> <p>Our hospitals now spend enormous time and money fighting between the fantasy bills generated by the hospital and the eventual contract price negotiated by the insurer. This serves no one well. In the middle, the consumer buys unnecessarily costly insurance for fear of getting cancer or some other catastrophic illness that will bankrupt them. </p> <p>Prospective payment for most office visits and procedures would dramatically drop the administrative costs of healthcare, now estimated at 18% of our healthcare dollars. A recent study showed that each and every doctor in America is spending $70,000/year on administrative expenses to process insurance claims. Most doctors I know have one biller for every 1 to 1.5 providers. </p> <p>90% or more of healthcare today is cost predictable. If payments were for these predictable services were paid up front, dramatic cost savings could be achieved.</p> <p>Insurers should get back to stratifying risks and get paid on managing risk in chronic or catastrophic care. Most of the routine care should be diverted to prospective payment with health savings accounts or some form of credit card deducted directly from health care funds. High deductible insurance should be left to serious medical incidents or chronic ongoing care. The time and energy spent today on the billing and collection aspects of routine healthcare is exactly what is wrong about the business of medicine today.</p> <p>Before concluding, I must state that I am highly skeptical that the Republican Party and the free market principles central to it's core values, is being unduly influenced by the medical insurance industry that is fundamentally flawed, but has extreme lobbying influence. This is the time to step up and offer a market based idea that everyone can understand.</p> <p>The status quo is not acceptable and significant and very fundamental changes are needed in how Americans pay for healthcare. The present debate has everything to do with serious flaws in the health insurance industry that are jeopardizing personal health and financial security and economic growth in the United States.</p> <p>While I disagree with virtually everything Nancy Pelosi says, she is right about the low moral aptitude of the insurance industry and she speaks for many Americans who have experienced the outright lies of the promise of private health insurance and the true economic realties of their business. It is the solution to this health insurance crisis, not the delivery of healthcare that we should be debating.</p> <p>Conservatives, who believe the free market is best and fairest arbiter of the economy, need at this very moment of crisis in my industry to lay out a very simple and fundamental premise going forward for Medicine: transparency in pricing in everything that we do. In combination with prospective payment for most straightforward transactions, the principle of commoditization can move our country forward by providing more care to more people at fair and reasonable pricing and again restore our medical system as the envy of the world, based on price and quality.</p> <p>I would hope that I could speak to you personally at some point in the near future on my ideas.</p> <p>Sincerely,</p> <p>Gregory L. DeSanto, M.D.</p>
10/06/2009 5:54:00 PM CDT
Jim Myers says ...
<p>Mr. Mackey,<br> I am a great fan of you store and now I am a great fan of youR analysis oF the health care problems and potential solutions. I think you are right on point. I am a board member of a large tax exempt health care organizaiton in Maryland. I am very distressed with the approach that Congress is taking in this matter.<br> Their solutions will creat more problems than solutions. The system needs major changes, but not the type proposed by the Presidnet and the Democratic majority. They are taking the easy way out.<br> Take over the system and throw money at the problems. This approach has never worked and will not produce a more accessable system. </p> <p>Your solutions attack the problems and would have a very positive impact on producing more affordable and accessable system, namely by realiening incentives and eliminating waste.<br> The Problem is the government has not articulated the goals of their proposals. They just want to take over the system and create larger government, which leads to increased influence government over our lives'¦. thus assuring these people of employment. It is all about the government sustaning itself and building on their base!!!!</p> <p>They firmly believe that we are unable to take care of ourselves so the government must do the job for us'¦. that is their soluttion and it is our problem!!!!</p> <p>Thank-you Mr. Mackey for taking the risk to tell the truth!!!'<br> THANKS!!!!!</p>
10/06/2009 10:16:00 PM CDT
johannes vandegraaf says ...
<p><strong>Inflammatory </strong>Mr Meckay trots out the usual phony Rightwing nostrums for the healthcare crisis.They 'look' good on paper but fail to address the fundamental problems.The high deductible health plans augmented by HSA accounts are OK for reasonably healthy people,but don't work for those with chronic (expensive) health problems,which is what accounts for over 70% of the health expenses in the US.Even if these folks can still hang on to a job,and have coverage,the costs are likely to overwhelm them.They will quickly exhaust their HSA<br> cushion and the high deductibles each year will make things very difficult for them.If they get terminated (all too likely) because of their condition or become too expensive to insure, pretexts will be found to get rid of them.<br> Then they are SCREWED, becoming uninsurable, are headed for bankruptcy&amp;destitution if not death.Some system!!<br> I would like to see John Mackey for instance offer special discounts for people living on foodstamps so that they can afford to adopt his healthy lifestyle.Living 'healthy' is not exactly cheap that's what he makes his money on.All this crap about 'savvy' healthcare consumers is just nonsense,should we all head for Med. School,including those with an 8th grade education. to get educated?.Get REAL the patients are pretty much at the mercy of their doctors,and those at the bottom of the socio-economic spectrum are both ignorant and largely clueless.The US has a very unhealthy population compared to otheradvanced countries,due in good part due to it's dysfunctional healthcare(non)system.Too many people have gotten no or inadequate care in the past,which ultimately increases costs a lot.As to this enhanced 'competition' among healthcare insurers,to bring down costs, unless they are financially rewarded for good healthcare OUTCOMES instead of for pleasing Wall St,they will continue their predatory practices, by finding pretexts for dumping those who cost them a lot.This 'rescission' of private insurance is all too common (close to 40% of highcost patients),SHAMEFUL.Mr Meckay should have addressed these issues instead of playing the shill for the WSJ</p>
10/07/2009 12:04:00 PM CDT
Patrice Martin says ...
<p>Mr. Mackey, thank you for your transparency and your continued commitment to our long term health. </p> <p>And thank you for including the core of the solution for health: personal responsibility. Individual responsibility to change the way we eat and live and corporate responsibility to promote biodynamic business.</p> <p>Your courage and clarity are admirable.</p> <p>Patrice Martin<br> Nutrition and Wellness Director</p>
10/07/2009 1:16:00 PM CDT
John B says ...
<p>Dear CEO Mackey,</p> <p>Thanks for your outspoken opposition to everything I believe in. You just helped me save a lot of money. I passionately disagree with what you say, but would defend with my life your right to say it'¦I just won't financially support you with my limited grocery dollars. No more Whole Paycheck. Trader Joe is now my main man. </p> <p>Best regards from your now former customer,</p> <p>John in Los Angeles</p>
10/07/2009 4:50:00 PM CDT
philip fischer says ...
<p>i am a physician in the state of alabama, and i just read your opnion in the WSJ tonight. I see the inner workings of healthcare daily and I strongly agree with your model and conclusions for success. I agree your plan will work broadly as the model will encourage people to invest personally in their own health partly because it is in their best interst to do so financially. Overall, it will encourage responsibility and decrease unnecessary consumption of healthcare. Thanks you for your personal sacrifice given in an attempt to guide our country past other rash and misguided plans. I hope our country is listening. Philip</p>
10/07/2009 10:44:00 PM CDT
Fausto says ...
<p>Mr Mackey,</p> <p>I am with you 100%. Just got back from Whole Foods. Love that artichoke dip!</p> <p>I calculated that if every person in the USA, assuming<br> 400,000,000 (million) were to have a government sponsored, ONE TIME ONLY, deposit of $2500.00 into an FSA account, that would cost roughly $100,000,000,000 (billion). That is far less than the monstrosity that is being proposed, and it will give people choice on where they what to spend it for basic health care.<br> Let us say at a Walgreens or WalMart clinic </p> <p>The able minded in mind and body can get jobs at firms that get tax credit for providing Catastrophic care with say $2500.00 deductibles, which you got already from the government. Even WalMart and Target (non union shops)can swing that for part timers I would think. All the local Target stores are hiring now. Yes there are no jobs!</p>
10/08/2009 10:15:00 AM CDT
Doug says ...
<p>JB,<br> Your comment about myopically supporting the president and his ideals and letting that interfere with your investment strategy may just put you in the position to benefit from this president's policies the most. </p> <p>The cult of personality that surrounds Obama is just amazing and is exactly the same thing that you were all so mad at the people that supported Bush of doing. You get all of your news from sources that support your POV (MSNBC, NPR, etc etc) This healthcare issue is to big and will have too long lasting of an impact on us all to be a partisan issue in which we all just fall in line behind and ideology.</p> <p>Please, for all of our sakes, expand your mind and horizons and listen to good ideas from those who have the practical experience of implementing them and not just the theoretical experience and 'hope' that they will work. Too large of a gamble at a time when our country can't afford a large mis-step.</p>
10/08/2009 1:07:00 PM CDT

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