Cigna CEO explains the problem with healthcare in America

The CEO of health insurer Cigna, David Cordani, says the problem with America’s healthcare system is that most of the money is being spent on intervention after people already are sick. Cordani believes we need to spend more money and resources keeping people healthy in the first place.

Cordani says that it makes sense for Americans to get health insurance through their jobs. He argues that employers have a vested interest in keeping employees healthy. Following is a transcript of the video.

Silverstein: And do you think it makes sense at all for healthcare to be tied to employers anymore given how much our workforce has changed?

Cordani: Yeah so in the United States greater than 50% of Americans today get their health services support through an employer. That, that is a manifestation from a long time ago post World War II wage controls that existed, but, but we are where we are. Answer to your question is yes, I do. And the reason why is: an employer actually has a vested interest in helping to keep their employees healthy, and productive, and present from a work standpoint. Two, the worksite and the culture of an employer create some mechanisms to engage an individual, ways to communicate, ways to provide on–site care, ways to provide peer support, program support, etc. So there’s incentive alignment, there’s culture you could pull against and support it, and then there’s delivery mechanism. So we think the answer is yes, and we have a ton of bright spots where we could point to employers that have innovated with us and we’ve innovated with them. And their employees and therefore their business is better off and those employees family members are better off because they’re getting better, more comprehensive healthcare.

Silverstein: And what do you think makes America different? Why are we spending so much on healthcare? Can you point to one thing that like our policies, or something in America that is a problem?

Cordani: Yeah, so our system is quite different, right? We’re a global company, we do business all over the world. So we’re able to see systems in the most developed OECD countries and developing countries around the world. There’s multiple differences. First and foremost, the United States is the largest sick care interventionist system in the world. We spend the majority of our money and resources addressing people once they’re sick. We need to spend some more of our resources keeping people healthy in the first case, and identifying people who are at risk of health events and lowering those health risks. Some other countries do that better through social service support, poor community based health support, etc. Secondly, we have more specialists and more hospitals per capita than any other OECD countries and less primary care, be it OBGYN, pediatrician, family practitioners, and, and we need to moderate that a little bit, to, again, help coordinate the whole person on the front end. There’s trade–offs in the way we’ve built our system. As a company we’ve had great success partnering with physicians through what we c–all, “Collaborative Accountable Care” relationships, we have 375 of which that are up and running with physicians, and another 125 with hospitals, and working more comprehensively. But in a nutshell, we wait too long in terms of trying to fix somebody once they’re sick, as opposed to engage on the front–end and keep people healthy in the first place, that’s where Cigna expends a lot of resources. Secondly, we spend a lot more money on the high cost intervention, as opposed to enabling the primary care physician, the geriatrician, the pediatrician, to have more resources to help to coordinate care for individuals. And we have a different pricing scheme relative to some of our services, be they pharmaceutical or otherwise, versus other parts of the world.

WATCH THE FULL INTERVIEW HERE: The CEO of health insurer Cigna on the Express Scripts merger, the problem with healthcare, and America’s opioid crisis