The Future of Cancer Control:
From Sick Care to Health Care
Tom Kean
9th Annual Nebraska Cancer Summit
October 4, 2013
Steve
Public Health and Medicine
are Noble Professions –
Intended to Help Our
Fellow Citizens Live the
Best Life They Can
The 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
THE Driver for Change
• In 2012, the USA spent over $2.87 trillion
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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.
PROBLEM
America has a “sick care” system, instead of
a “healthcare” system
BUT WHAT DOES THAT
REALLY MEAN?
A ‘Sick Care’ System
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Too much preventable disease
A cultural mindset focused on ‘fixing’
Misaligned incentives
Fascination with new technologies
Resistance to ‘change’
Entrenched bureaucracy
The Result
• We spend more than any other nation per
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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 Change
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
315,000,000+ people from
an acute care mindset to
one that prioritizes
preventive behaviors?
How do you make a population
level shift?
Levels of Intervention
policy
community
institution
individual
Not A Project at a Time!
A “Man on the Moon”
Approach
Requires:
• A vision for foundational, societal level
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change
A long-term strategy
Serious investment
Leadership – national, state, local
Engagement of all segments of society
Public will
Major mindshift
Important Prevention-Related
Trends to Watch
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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
Health and Medicine
Improving Quality of Life
• Importance for cancer survivors
• Palliative and hospice care
• Cancer and health disparities
Quality of Care
• Patient-centered care
• Performance vs. procedure-based
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incentives
Workforce
– Pressures
– Dynamic changes
Linda
Contact information:
tkean@cchangetogether.org
www.c-changetogether.org