The Future of Cancer Control:The Future of Cancer Control: FromFrom Sick Care Sick Care toto Health CareHealth Care

Tom KeanTom Kean99thth Annual Nebraska Cancer Summit Annual Nebraska Cancer SummitOctober 4, 2013October 4, 2013

SteveSteve

Public Health and Medicine Public Health and Medicine are Noble Professions – are Noble Professions –

Intended to Help Our Intended to Help Our Fellow Citizens Live the Fellow Citizens Live the

Best Life They CanBest Life They Can

The Big ConundrumThe Big Conundrum

• Doing the RIGHT things for ‘health’

In light of

• Dwindling and misaligned resources for doing the RIGHT things

Our Health Care Expenditures are Our Health Care Expenditures are THE Driver for ChangeTHE Driver for Change

• In 2012, the USA spent over $2.87 trillion on health care.

• Our health care spending in 2012 compared to TOTAL GDP by nations in the world was fell between France at 4th and Germany at 5th.

• This figure represents 18% of our own GDP and is growing!

• This is unsustainable.

PROBLEMPROBLEM

America has a “sick care” system, instead of a “healthcare” system

BUT WHAT DOES THAT BUT WHAT DOES THAT REALLY MEAN?REALLY MEAN?

A ‘Sick Care’ SystemA ‘Sick Care’ System

• Too much preventable disease• A cultural mindset focused on ‘fixing’• Misaligned incentives• Fascination with new technologies• Resistance to ‘change’• Entrenched bureaucracy

The ResultThe Result

• We spend more than any other nation per capita on health care

• We spend twice as much on health care as the 2nd highest country

• We spend 75% of our health care dollars treating preventable, non-communicable diseases.

• And among the top 30 industrialized nations on earth, we rank 24th in life expectancy.

Opportunities for ChangeOpportunities for Change

Prevention / Risk-Reduction Prevention / Risk-Reduction

Most people do not know, believe, or act on the fact that at least 50% of all cancer deaths are preventable through changes in diet, exercise, smoking and screening

So how do we move So how do we move 315,000,000+ people from 315,000,000+ people from an acute care mindset to an acute care mindset to

one that prioritizes one that prioritizes preventive behaviors?preventive behaviors?

How do you make a population How do you make a population level shift?level shift?

Levels of Intervention

Not A Project at a Time!Not A Project at a Time!

A “Man on the Moon” A “Man on the Moon” ApproachApproach

Requires:Requires:

• A vision for foundational, societal level change

• A long-term strategy• Serious investment• Leadership – national, state, local• Engagement of all segments of society• Public will• Major mindshift

Important Prevention-Related Important Prevention-Related Trends to WatchTrends to Watch

• ACA benefits for preventive services• Investment in prevention• Industry out in front• Changing ourselves – personally and

organizationally• Consumerism• The ‘policy’ debate• The ‘genetic’ revolution

The Overlapping of Public The Overlapping of Public Health and MedicineHealth and Medicine

Improving Quality of LifeImproving Quality of Life

• Importance for cancer survivors• Palliative and hospice care• Cancer and health disparities

Quality of CareQuality of Care

• Patient-centered care• Performance vs. procedure-based

incentives• Workforce

– Pressures– Dynamic changes

LindaLinda

Contact information:Contact information:

tkean@c-changetogether.org

www.c-changetogether.orgwww.c-changetogether.org