Business, Ethics and American Healthcare Reform
Boisi Center for Religion and American Public Life
On April 24, the Boisi Center hosted a panel on the business and ethics of healthcare reform. Boisi Center associate director Erik Owens moderated the panel of prominent guests: Cathleen Kaveny, the Darald and Juliet Libby Professor of law and theology at Boston College; John LaMattina, a former senior vice president and president of research and development at Pfizer and currently a senior partner at PureTech Ventures; Peter Markell, executive vice president, chief financial officer, and treasurer of Partners HealthCare Systems; and Eric Schultz, president and chief executive officer of Harvard Pilgrim Health Care. Each panelist brought a unique and exceptionally well-informed perspective to the practical and ethical issues surrounding the Affordable Care Act (ACA, commonly known as Obamacare) and healthcare reform more generally.
The panel sought to rise above the hyperbolic language of partisan politics in order to provide a more nuanced assessment of the challenges and future of American healthcare and insurance reform. Markell noted that the difficulty of addressing high costs stems from an imbalance in the financial structure: three percent of the population drives fifty percent of healthcare costs. Speaking from his perspective in the insurance industry, Schultz added that the ACA is counting on young, healthy people to con- tribute to the insurance market at rates disproportionate to their use of healthcare. LaMattina explained that the high costs of drug prices reflect the expensive research and development required to bring a drug to market.
Kaveny supplemented the discussion of practical business concerns by outlining a Catholic ethical perspective. She spoke of the long history of community-based healthcare within the Catholic tradition, and reminded the audience that many of Jesus’s miracles were focused on healing the sick and marginalized members of society. Catholic-run hospitals have become one of the most important providers of healing and treatment in the United States. The Catholic moral tradition has long maintained that individuals have a right to basic healthcare. The panel agreed, though, that what constitutes “basic health care” is still a matter of intense debate in this country.
The panel discussed whether implementation of the ACA marks a shift toward the ethical understanding Kaveny laid out. It seemed generally agreed that while the new law moves in the direction of positive reform, it leaves many problems unaddressed while also creating new problems. Owens pushed the panel to say what an appropriate arrangement of cost-sharing of healthcare expenses across society would be, but panelists were not able to reach a consensus on the question.
Following the discussion, members of the audience—including those viewing the live broadcast online—had the opportunity to ask the panel specific questions. The panelists and audience discussed difficulties raised by Medicare guidelines based on outdated life expectancy projections. Additionally, the panel agreed that the politicization of healthcare has prevented the adoption of effective solutions to the rising costs and need for healthcare and insurance. By bringing together business, ethical and theological concerns about a crucial topic, this terrific conversation served as a perfect closing event of the year.