Mar. 9, 2010 : Athenahealth CEO Jonathan Bush on health care reform

>> PRESIDENT OBAMA IS IN

CAMPAIGN MODE THIS WEEK, THIS

TIME IT'S NOT TO WIN VOTES BUT

TO CONVINCE AMERICANS TO

SUPPORT HIS HEALTH CARE PLAN.

THE PRESIDENT IS FOCUSING ON

PRESSURING INSURANCE COMPANIES

TO KEEP EXPENSES DOWN.

ATHENA HEALTH C.E.O. JOHN

ATHUN BUSH SAYS HIS COMPANY

ALREADY HELPS 15,000 THERES IN

--

DOCTORS IN 43 STATES REDUCE

COST THROUGH OUGHT MATED BILL

AND DIJ TIDESING MEDICAL

RECORDS.

JONATHAN BUSH IS HERE.

>> VERY EXCITED TO BE HERE.

>> I UNDERSTAND YOU'RE THE MAN

WITH THE ANSWERS.

SO HERE'S WHAT I'VE GOT FOR

YOU.

I GOT THIS LETTER TODAY.

IT'S A LETTER, A LITTLE SAD,

BUT THIS GUY KEPT TRACK OF HIS

PREMIUMS SINCE 1997.

THIS YEAR HE'S A MARRIED MAN,

WITH A 16-YEAR-OLD DAUGHTER.

THIS YEAR HIS PREMIUMS FROM

TUFTS, WENT UP 43% IN 2010 TO

$2,320 A MONTH.

FOR THREE PEOPLE.

I DON'T THINK HE MAKES MUCH OF

A SALARY, MAKES $25,000

ROUGHLY.

WHAT IS GOING TO CHANGE FOR

THIS GENTLEMAN, IF THE OBAMA

HEALTH CARE PLAN GOES THROUGH.

IS IT GOING TO GO UP, DOWN,

STAY THE SAME?

>> SO ONE OF THE BIG LEAGUES

IN THE COST OF HEALTH CARE --

ONE OF THE BIG LEAKS HAS BEEN

THE COST OF MEDICARE.

SO IT'S HARD FOR THE

GOVERNMENT TO GANG UP ON SOME

POOR SENIOR AND SAY NO, YOU

HAVEN'T CAN'T HAVE THAT

HYSTERECTOMY.

THE GOVERNMENT IS NOT GOING TO

SAY NO YOU CAN'T HAVE IT.

SO ANYTHING THAT IS PROVEN TO

KEEP ANYONE ALIVE IN ANY WAY

HAS TO GET APPROVED.

BUS UNLIKE STINGY, GREEDY

HUNGRY BUSY HMO'S, THE

GOVERNMENT IS OWNED AND RUN BY

ALL OF US AND IT'S EASIER TO

SAY YES AND NO.

SO IT'S CREPT UP.

SO I THINK WHAT I HEAR PEOPLE

COMPLAINING ABOUT ON THE

GOVERNMENT OPTION OF A

COMMERCIAL, IN THE COMMERCIAL

SPACE, IS THE SAME THING

HAPPENING, THAT THE GOVERNMENT

OPTION WILL GET MORE AND MORE

GENEROUS, THEY'LL JUST LIKE

AMTRAK, THEY'LL HOLD THE

PRICES AT A CERTAIN PLACE AND

LOSE MONEY, BUT SAY SOON WE'RE

GOING TO MAKE IT UP ON VOLUME,

WHEN THE SUPER FAST WHATEVER

IT IS HAPPENS IN 2097.

THAT IS THE BIG CONCERN.

AND THE COMMERCIAL GUYS GET

DRIVEN OUT OF BUSINESS.

>> BUT WHAT'S WRONG WITH THAT?

>> WELL, IF WE --

>> IF THIS KEEPS HAPPENING TO

PEOPLE THE COMMERCIAL GUY WILL

PUT HIMSELF OUT OF BUSINESS

BECAUSE THIS GUY WILL SAY I

CAN'T DO THIS ANY MORE, I'VE

GOT TO GO ON THE PUBLIC TILL.

>> RIGHT.

IT AN EXPANSION OF THE TILL.

WHAT WE'VE EXPERIENCED SO FAR

IS IT SEEMS AS THOUGH THE

PRIMARY DRIVER OF THE

EXPANSION HAS BEEN THE

GOVERNMENT SPONSORED PROGRAMS,

THOSE ARE THE ONES WHERE

UTILIZATION HAS BEEN ALLOWED

TO GO UP AND UP MOST

AGGRESSIVELY.

SO WE ADD ANOTHER ONE AND IT'S

EASY TO KEEP THAT GOING.

WHAT WE REALLY NEED TO DO IS

DISCONNECT THE COMMERCIAL

MARKET MORE FROM THE

GOVERNMENT MARKET.

SO IT'S EASIER FOR A

COMMERCIAL PLAN TO SAY I KNOW

THAT THAT'S ALLOWED WHEN

YOU'RE ON MEDICARE, BUT IF YOU

WANT THE DISCOUNT PREMIUM, YOU

CAN'T GET THE THIS OR. THAT

>> HELP US OUT HERE, WHY THESE

INSURANCE PREMIUMS HAVE GONE

UP SO DRAMATICALLY.

IN THE LAST COUPLE YEARS.

WAY OUT OF WHACK WITH ANYTHING,

WITH THE COST OF LIVING, WITH,

BY HIS CALCULATION, 348% IN 10

YEARS.

WHY?

>> MY SENSE IS THAT IF YOU

LOOK AT THE CLAIMS DATA ACROSS

THESE YEARS, WHAT HAPPENS IS,

UTILIZATIONS GO UP.

THE AMOUNT OF STUFF THAT GETS

UTILIZED GO UP.

THERE'S TWO REASONS FOR THAT,

ONE GOVERNMENT PLANS DON'T

KNOW HOW TO SAY NO. SO THERE

WAS A BRIEF PERIOD IN MATERIAL

90s ABOUT FIVE OR SIX YEARS

WHEN HMO'S REALLY WERE

AGGRESSIVE AND THEY KEPT

PREMIUMS THE SAME, WHILE

HEALTH CARE WAS GETTING

RELATIVELY CHEAPER, FOR ABOUT

FIVE YEARS THERE.

AND OF COURSE EMPLOYERS AND

INDIVIDUALS AND ACTIVIST

GROUPS SAID BUT I REALLY NEED

THIS TRANSPLANT AND LOOK AT

THIS INNOCENT PERSON WHO WILL

DIE, AND WHO WILL BE THE ONE

TO OWN KILLING THIS PERSON.

BARBARA WALTERS WAS WALKING

AROUND THE HEADQUARTERS OF

HUMANA.

SO THAT PROBLEM IS NOW BEING

ACCENTUATED, I THINK, BY THE

NARROWING OF THE OPTIONS.

SO THE GOVERNMENT OPTION ISN'T

A NEW OPTION, IT'S A NEW

UNDERWRITER OF THE SAME OLD

OPTION.

AND WHAT I'M HOPING SOMEBODY

SAYS IS, GEE, THESE GUYS CAN

DO A LOT OF STUFF FOR YOU A

LOT OF DIFFERENT WAYS, ONE OF

OUR NEW CLIENTS, MINUTE CLINIC,

THEY HAVE THESE CLINICS THAT

CAN DO A LOT OF WHAT A DOCTOR

CAN DO PRETTY DARN QUICK AND A

LOT CHEAPER.

STARTING AT THE LOW END OF THE

FOOD CHAIN, OFFERING A WIDER

AND WILDER RANGE OF OPTIONS.

MAYBE THIS GUY DOESN'T

ACTUALLY NEED EVERYTHING

THAT'S INCLUDED IN HIS --

>> MAYBE NOT.

HE PROBABLY DOESN'T KNOW.

>> RIGHT NOW IT'S ILLEGAL TO

OFFER ANYTHING OTHER THAN

EVERYTHING IN MASSACHUSETTS.

>> IT'S THE SAME WAY ABOUT CAR

INSURANCE.

YOU SHOULDN'T HAVE TO HAVE

COLLISION IF YOU DON'T WANT

IT.

>> EXACTLY.

WHAT KF CAR INSURANCE ONLY

CAME WITH GASUPS, DELIVERY OF

THE CAR TO YOUR HOUSE AND CAR

WASHES.

CAN YOU IMAGINE HOW MUCH THAT

WOULD COST?

YOU'D GO WAIT, I LIKE TO USE

THE CHEAP GAS.

OH WAIT, IT COVERED, YOU NEED

TO USE THAT BECAUSE IT'S

COVERED, AND YOU SAY, WELL, I

MIGHT AS WELL BUFF IT TOO,

EVEN THOUGH IT'S A 1987 OPEL.

THAT IS WHAT'S HAPPENING,

WE'RE TAKING A 1987 OPEL AND

WE'RE BUMPING THE HECK OUT OF

THEM BECAUSE IT COVERED.

WHAT WE'RE DOING AT ATHENA

HEALTH IS TRYING TO GET THAT

CLARITY, THAT SHOWS WHEN YOU

DO THIS, THIS IS WHAT I COSTS,

INTO AT LEAST THE DOCTOR'S

HANDS.

SO WHAT'S IRONIC TODAY IS THE

DOCTOR DOESN'T EVEN KNOW.

>> SHOULD THEY KNOW?

>> YES, I THINK SO.

I THINK THEY OUGHT SO SAY I

CAN DO THIS, BUT THE TOTAL

NUTS FOR YOU, IS GOING TO BE X

THOUSAND DOLLARS.

>> IT'S NOT, A LOT OF PATIENTS

WANT THEIR DOCTORS TO PUT

THEMSELVES ABOVE IT.

>> SURE THEY DO, UNTIL THEY

SAY GEE WHY IS MY PREMIUM 43%

HIGHER THAN LAST YEAR.

WELL, YOU PUT YOURSELF ABOVE

THAT, AND THE PROBLEM IS AT

SOME POINT, IT DOESN'T MATTER,

IF WE SHIFT TO IT THE

GOVERNMENT WE GET TO DELAY IT

FOR A WHILE.

WHAT DID MAGGIE THATCHER SAY,

SOCIALISM IS MY FAVORITE THING

BUT EVENTUALLY YOU RUN OUT OF

OTHER PEOPLE'S MONEY.

WHEN YOU SHIFT IT INTO THE

BIGGER POOLS, EVENTUALLY THE

POOLS GET OUT OF CONTROL.

AND WHO IS GOING TO CONTROL

THE WHOLE POOL.

>> WHAT KIND OF RESPONSE HAVE

YOU GOTTEN?

IS THERE A CURIOSITY FACTOR?

>> IN GENERAL RIGHT NOW HAVE

YOU THIS MALAISE, WHERE THE

DOCTOR SAYS I DON'T KNOW I'M

JUST GOING TO DO WHAT I CAN DO,

I'M GOING TO SEE THE PATIENTS

THE WAY THEY WANT TO BE SEEN,

I'M ABOVE IT.

WHAT WE SAW PREOBAMA AND WHAT

WE EXPECT TO CONTINUE IS A

RISE OF THESE CONSUMER

DIRECTED HEALTH PLANS, WHERE

THE CONSUMER ACTUALLY HAS A

BIG PIECE OF THE DOLLAR AMOUNT,

MAYBE THE FIRST $2,000 OR

SOMETHING, THEY OWN THEMSELVES

AND THEY'RE NOW GOING TO START

SAYING TELL ME AGAIN WHAT YOU

WANT TO DO TO ME AND WHY?

AND ARE THERE ANY ALTERNATIVES,

LIKE YOU WANT TO DO A CAT SCAN

TO SEE IF I HAVE SOMETHING?

CAN I JUST CALL YOU AND TELL

YOU IF I FEEL BETTER OFF THE

WEEKEND?

>> I CAN TALK ALL DAY, ABOUT

PEOPLE HAVE BECOME HYSTERICAL

ABOUT THEIR OWN HEALTH.

>> WE CAN SEE THAT IN COLOR,

AND G. E. IS GREAT WITH THAT.

>> WE'RE OUT OF TIME, BUT I'M

GOING TO HAVE YOU BACK, WE'RE

GOING TO CONTINUE THIS

CONVERSATION.

>> GOOD, I CAN'T WAIT.

>> THAT IS IT FOR "GREATER

BOSTON".

TUNE IN TO THE NEW 89.7 WGBH

AT NOON FOR MY RADIO SHOW.

TOMORROW NIGHT BACK BAY BLIGHT,

PLUS THE LATEST PHENOMENON IN

SOCIAL NETWORKING, THAT'S

TOMORROW AT 7:00.

I'M EMILY ROONEY.

GOOD NIGHT+++ATH0