A three-point plan to fix health care in the U.S.

By Becky Quick,

As debate rages about the troubles millions are having in trying to sign up for health insurance through the government website, a bigger ailment is occupying the mind of Mark Bertolini. The chairman, CEO, and president of insurance giant Aetna, Bertolini is focused on a longer-term problem: how to treat the nation’s ballooning health care costs, which rose to a staggering $2.7 trillion last year.

Bertolini has a seat on the frontlines of the debate. Aetna insures about 44 million Americans. But he isn’t just a technocrat. He’s also had more than his share of firsthand experiences with the medical system, with his son, Eric.

He has a simple three-point plan to heal our ailing health care system.

>ELIMINATE FEE FOR SERVICE. His first priority is to change the way we pay for care. Instead of fee for service, hospitals and doctors should be paid for a good outcome.

>FOCUS ON HEAVY USERS. 5% of Medicare patients are responsible for 43% of the $550 billion spent on the program. To find big savings, you have to target where the money is being spent.

>RESTRUCTURE THE DELIVERY SYSTEM. Send all the hearts to Cleveland Clinic. Send all the cancers to Memorial Sloan-Kettering. Laying out a plan to develop regional centers of excellence around the country.

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