Aspen Ideas Festival 2012
Discover the big ideas being explored at this seminal event through the voices of Booz Allen leaders.
Booz Allen EVP Jimmy Henry (center right) moderated a panel with (L to R) Peter Orszag, Elizabeth Nabel, and Martin Gaynor
Healthcare and the US Economy
Booz Allen Executive Vice President Jimmy Henry moderated a panel titled “Health and the US Economy” at the Aspen Institute’s Aspen Ideas Festival on July 1, 2012. The panelists included Peter Orszag, vice chairman of global banking at Citigroup; Elizabeth Nabel, president of Brigham and Women’s Hospital and professor of medicine at Harvard; and Martin Gaynor, the E.J. Barone Professor of Economics and Health Policy at the Heinz College of Carnegie Mellon University. Henry shares his observations on the topic and the role Booz Allen plays with clients in coping with the changing healthcare landscape.
The panel addressed the question of whether the healthcare sector would drive or drag down the economy. Was that question answered?
This is not an easy topic. These panelists are people who are closer to the problem than anyone else in the United States, so it was encouraging when they said we won’t have this solved tomorrow, but that it’s doable. I thought that was a great takeaway.
What were the most important points to come out of the discussion?
There were a handful. That clearly the country is moving away from a fee-for-service medical system, and toward other models like the risk-sharing system being implemented at Brigham and Women’s Hospital. That in spite of press to the contrary, there has been a deceleration of the growth rate in healthcare spending over the last 10 years. That in some important areas, cost reduction is at hand. Hospitals and insurance companies are meeting the challenges more aggressively and quickly than the average citizen understands. And lastly, what struck me was the degree of optimism shared by the panelists about the potential to gain from these activities.
So this a period of innovation in healthcare delivery?
The fact that things are moving so rapidly at a place like Brigham and Women’s Hospital in Massachusetts, as Dr. Nabel described, is encouraging. They are well down the path of shifting from fee-for-service to risk sharing. It’s a very innovative time both on the ground at places like Brigham and Women’s and in other areas of our healthcare delivery economy, as Peter Orszag and Martin Gaynor pointed out. You wouldn’t know that unless you stopped and asked the question, like we did with the panel.
Please share your birds-eye perspective on the challenges we face with the healthcare system.
Healthcare is different than other industries. It was clear from the conversation that the solution can’t be completely market-driven. In some respects, healthcare is like defense in that there is a legitimate role for government. The question is about the size and extent of that role, and where is the inflection point between individuals paying for healthcare because they can and healthcare becoming a legitimate function of our government to support our fellow citizens. We need to find that balance between policymakers and pragmatists to get us to the right place.
What role is Booz Allen playing with its clients as they face the complex challenges of the healthcare system?
Booz Allen is segmenting the issue into areas where we can apply our insights and strengths to the greatest effect for clients in the private sector and government. A good example is our work with the Department of Veterans Affairs, where we’re helping them improve the application and delivery of selective types of specialized care for veterans with brain injuries and other extremely challenging health issues. Our expertise is in bringing the money and partners in both the public and private sectors together to face these challenges.
Can you give an example of Booz Allen applying its broad experience with a variety of clients to bear on the complex nature of healthcare?
Information technology. Booz Allen applies its expertise in that area to healthcare across the federal government. We are particularly effective—based on what our clients tell us—at the VA, the Centers for Medicare and Medicaid Services, and the National Institutes of Health, among other agencies. And that’s thanks in part to the range and depth of experience we bring from our work with clients in other areas. We’re not doctors—although we have doctors on staff—but our work with healthcare agencies on a range of issues, including IT, is one of our absolute strong points.
What can Booz Allen do to help client address the escalating costs of healthcare?
Booz Allen has exceptional capabilities in helping our clients understand their cost drivers. Most clients know what those drivers are at a macro level; we help them go down two or three layers to identify inefficiencies in their systems and processes. We help our clients optimize value by extracting costs where there are variants from their benchmarks and by providing solutions that show an understanding of how healthcare is delivered.Read more and comment
For Booz Allen Executive Vice President Rich Wilhelm, who leads the firm’s relationship with the Aspen Institute, the themes emerged from the 2012 Aspen Ideas Festival: the changing nature of our democracy, the need to transform cities, and the issue of war and peace.
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Moderator Rich Wilhelm (right) with panelists (R to L) Sanford Levinson, Pamela S. Karlan, Richard H. Pildes, and Jed Rubenfeld
Our Constitution at a Crossroads: Does the System Need Reform?
Booz Allen Executive Vice President Rich Wilhelm moderated a panel discussion titled “Our Constitution at a Crossroads: Does the System Need Reform?” at the Aspen Institute’s Aspen Ideas Festival on July 2, 2012. The panel included Pamela S. Karlan, the Harle Montgomery Professor of Public Interest Law at Stanford Law School; Richard H. Pildes, a professor of constitutional law at New York University School of Law; Sanford Levinson, the W. St. John Garwood and W. St. John Garwood, Jr. Centennial Chair at the University of Texas; and Jed Rubenfeld, the Robert R. Slaughter Professor of Law at Yale Law School. Wilhelm shares his observations about the panel discussion below.
Today you talked with constitutional scholars about the possible need for reform of the US Constitution. What were the overriding themes?
Something everybody agreed on is that not only is the political environment polarized, but it’s hyperpolarized to where there is no longer a rational center that has any voice. So the prospect for compromise under the current political party structure is not very optimistic.
It was very interesting that the framers of the Constitution did not anticipate or want the formation of political parties. They wanted different, smaller factions and regions coming together to talk about what was going on and then come up with laws.
The view on the panel was that it is the hyperpolarization of the political system that is more responsible for the problems we have now than anything to do with the checks and balances in our system of government.
How is Booz Allen helping its clients adjust to the uncertain, hyperpolarized political and budget atmosphere?
The short answer is we can provide some historical perspective. Most of the people working in government today have never lived through anything like this before. Has this occurred before? Yes it has. Is what is happening now different than what occurred before? The jury is still out on that. But I think essentially we have one thing now that we didn’t have before: We’ve got this monstrous deficit.
Do you see a fix to this situation?
There is going to have to be some permanent resetting of what government does unless either one of two things, but more likely both, happen: tax reform, which in some way increases revenue, and entitlement reform, which deals with issues like raising of the retirement age, getting rid of fraud in Medicare and Medicaid, and reducing certain forms of other entitlements. That’s the only way you get the budget under control, and those are very difficult issues in a hyperpolarized environment.
At the end of the discussion, the panelists provided quick solutions to our constitutional and governance challenges. Was there one you agreed with more than others?
I loved what Pam Carlan said: We need to change the education system by requiring Civics classes in high school again, and then after 15 years require mandatory voting.
Why was that your favorite?
Because it’s working very well in Australia, where they require everybody to participate in the political process. You can’t force people to vote, but you can force them to show up at the polls. A couple things that happen if you’ve got universal voting: One is that we are less a slave to the hyperpolarization in the political system, because everybody can’t be hyperpolarized.
It would be a big issue in this country—do we require people to vote or not? But the government requires people to do all sorts of things. It requires you to buy car insurance. If you want to own a house and finance it, you’ve got to have fire insurance. If you want to build a big commercial building, you’ve got to put sprinklers in there.Read more and comment