State Leadership Conference

America's health-care system is a lot like the MTV show where an old, battered car is tricked out with a flashy exterior, while the engine is completely ignored.

That's how futurist and health-care analyst Ian Morrison, PhD, described the state of the U.S. health-care system during his keynote address at the 2006 State Leadership Conference.

"It looks great, it has a fantastic sound system and nice seats, but it will break down if you try to drive it anywhere," Morrison said.

His talk humorously made several distressing points about rising health-care costs, and the increasingly unhealthy habits of Americans driving those costs.

Looking back to 1990, Morrison said what people expected back in the heady days of health-care reform was universal health insurance coverage, physicians and nurse practitioners working together in interdisciplinary treatment teams and an emphasis on primary care. Instead, doctors still practice in "onesies and twosies," the number of uninsured is rising and the affluent get the best care, said Morrison.

Since 2000, health-care premiums have risen 73 percent while workers' earnings have grown only 15 percent, according to the Employer Health Benefits 2005 annual survey. As health care gets more expensive, the number of uninsured is expected to rise from the 2003 estimate of 45 million to 56 million by 2013, according to a paper written by University of California, San Diego professors Todd Gilmer, PhD, and Richard Kronick, PhD. Rising costs cause small employers to stop offering expensive health-care coverage and individuals to stop buying into plans on their own, Morrison said.

Morrison identified health problems linked to obesity as a big part of the reason for rising health-care costs. The percentage of obese Americans grew significantly in the past 20 years, as lack of exercise, longer work hours, decreased smoking and bigger, calorie-laden fast-food servings drove up Americans' average body mass index measurements.

Discussing solutions, Morrison told the assembled psychologists they must help drive down those costs by helping people manage their personal behavior in everything from eating less and exercising more to complying better with medical treatment.

"Your voice needs to be embedded in that discussion about behavioral change," he said.

-C. Munsey