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John Leifer, CEO of The Leifer Group, Leawood, Kan.

| 02.01.2016 |

The Leifer Group provides strategic services designed to enhance the effectiveness of companies and organizations within the healthcare industry. We spoke with the company's founder and leader, John Leifer, regarding the current state of U.S. healthcare.


Q: Obamacare has been the law of the land for the past five years. What kind of a change has it brought to the state of health care, especially in regard to what businesses offer their employees?


John Leifer: "Uneven" is the best word I can use to describe the effects of Obamacare, since there is considerable variation across states relative to changes to the number of uninsured, with the South faring the worst. Overall, however, Obamacare has certainly helped to broaden access/coverage, which was its primary objective.


Where Obamacare fails, in my eyes, is addressing the profound dysfunction at the very core of our health care system. Rather than correct the major problems endemic in health care, it has opened up the funnel to allow more people to pass into a desperately broken system. These problems result in a stunning lack of value in health care delivery, including tremendous variations in pricing, quality, and safety across providers nationally.


Q: How can employers encourage their employees to be more health literate?


John Leifer: Employers can integrate health literacy initiatives into their broader wellness efforts, but must do so with caution. The efforts must truly be designed to improve the employees' health and personal stewardship responsibility for that health without coercive penalties for failing to engage in the corporate program.


Q: You advocate that companies should refuse to pay for any changes associated with hospital-induced injuries or illnesses. Can they get away with this? And who pays if the company refuses?


John Leifer: I advocate for a lot of things that are very difficult to accomplish. One could either call that "idealism" or "vision." If it gets accomplished, it's vision.


It is absolutely absurd for payers, whether it is an insurance company, self-insured corporation, or individual, to have any economic responsibility for injuries or illness directly attributable to medical care. We use the fancy term "iatrogenic events" to refer to such problems. Iatrogenic events were one of healthcare's dirty little secrets - that was until the magnitude of such injuries and illness were disclosed in 1999 in an Institute of Medicine Report entitled "To Err is Human." The most stunning thing about that report is that, despite catalyzing extraordinary commentary about the need for change, little has actually changed relative to safety in health care. Corporations have the power to demand safer, higher quality, and more affordable care - if they come together and leverage their combined power in effective ways.


Q: Is U.S. health care able to be reformed? Or is it just too big and out of control?


John Leifer: I pray it can be reformed, though it will require a Herculean effort. In 2014, my book, The Myths of Modern Medicine: The Alarming Truth About American Health Care, was published by Rowman & Littlefield. If you want to take off the blinders and understand the extraordinary amount of work required to transform our health care system into one that provides appropriate care, simply read my book. Americans pay far more and receive far less in terms of health benefits from our health care system than any other populous on the face of the earth. Call me crazy, but I think that's a problem!


John Leifer is online at http://leifer.com.