By Gregory Rutzen, Office of Institutional Advancement While Congress spent another day immersed in debates on healthcare reform, leaders in the Texas Medical Center participated in a panel discussion, sharing their visions for healthcare coverage and how to pay for it.

The Nov. 3 event at The University of Texas Health Science Center at Houston was presented in conjunction with The University of Texas McCombs School of Business. Kevin Dillon, M.B.A., UT Health Science Center at Houston executive vice president and chief operating and financial officer, moderated the panel discussion at the Beth Robertson Auditorium of The Brown Foundation Institute of Molecular Medicine for the Prevention of Human Diseases (IMM).

Panelists were Thomas R. Cole, Ph.D., The John P. McGovern, M.D. Center for Health, Humanities and the Human Spirit at UT Medical School at Houston; Leon J. Leach, M.B.A., The University of Texas M.D. Anderson Cancer Center; Osama Mikhail, Ph.D., The University of Texas School of Public Health at Houston; and Pauline Vaillancourt Rosenau, Ph.D., UT School of Public Health.

Befitting  the UT business school backdrop, healthcare cost drew the most attention from the panelists and audience members. All experts agreed that controlling costs is a critical component to any reform plan, but in the end the four panelists proposed four different solutions to this complex problem.

Cutting wasteful administrative costs would be the place to start, asserted Rosenau, who cited the Medicare, Medicaid and Veterans Administration systems as models of service providers that operate without high administrative costs.

Mikhail's solution would involve changing the way reimbursements are determined in order to pay higher reimbursements "upstream," that is, at the prevention, promotion and education end of the healthcare spectrum. This may add short-term costs, Mikhail recognized, but would provide long-term cost savings.

Leach proposed nationalizing medical malpractice litigation limitations like those currently in place in Texas, letting insurers compete across state lines and moving toward a value-based competitive system for setting fees for services.

Cole argued for having a public healthcare option that would serve to provide the possibility of keeping the health insurance companies honest and that would expand access and coverage the most.

"These are complicated issues that don't reduce themselves well to simple answers," Dillon noted. "We are fortunate to have this outstanding panel of experts right here in the Texas Medical Center."

The panelists are considering reprising their presentation to a largely School of Public Health student audience within the next few months.