Saum Sutaria, M.D.

Those regulations have improved the consistency of performance of the US healthcare system.

Those regulations have improved the consistency of performance of the US healthcare system.

Right. So some fraction of what they've done has really, really helped. And you can't argue with that. And similarly, regulations that have been placed in other parts of the industry. So we may be overregulated, but you can't discount the value of some of that regulation.

Right. So some fraction of what they've done has really, really helped. And you can't argue with that. And similarly, regulations that have been placed in other parts of the industry. So we may be overregulated, but you can't discount the value of some of that regulation.

One of the things that I think we get very much caught up in is the concept that our system, which is more of a fee-for-service system versus some kind of value-based population health system would be the change that would be required.

One of the things that I think we get very much caught up in is the concept that our system, which is more of a fee-for-service system versus some kind of value-based population health system would be the change that would be required.

And the interpretation is always, well, all these other countries who spend less, they must be a population health system or a value-based care system because everybody's in one insurance pool. What we've said in our discussion is, no, it's a supply-side intervention. They just constrain and limit cost and infrastructure. They just decide. what's going to be accessible.

And the interpretation is always, well, all these other countries who spend less, they must be a population health system or a value-based care system because everybody's in one insurance pool. What we've said in our discussion is, no, it's a supply-side intervention. They just constrain and limit cost and infrastructure. They just decide. what's going to be accessible.

That's what drives the difference in their cost. And by the way, for all those economies, again, remember, their healthcare expenditures went from 4 to 11 or 12. That's a massive increase for those countries too. It's just not as big as ours. So I think the concept here, you have to put this in perspective.

That's what drives the difference in their cost. And by the way, for all those economies, again, remember, their healthcare expenditures went from 4 to 11 or 12. That's a massive increase for those countries too. It's just not as big as ours. So I think the concept here, you have to put this in perspective.

The interventions that have fundamentally tried to change the workflow in healthcare, value-based care, most of them haven't succeeded. I mean, look at the companies and other organizations that have been in this space, despite the best of creative intentions. Many of them have not succeeded.

The interventions that have fundamentally tried to change the workflow in healthcare, value-based care, most of them haven't succeeded. I mean, look at the companies and other organizations that have been in this space, despite the best of creative intentions. Many of them have not succeeded.

I would argue Medicare Advantage is the most important at-scale value-based construct that has been somewhat successful. But most of the innovation in and around that has not been very successful. And that doesn't mean it's not going to get there at some point. Part of American ingenuity is trying and failing and trying and failing and trying and failing until you find a model that works.

I would argue Medicare Advantage is the most important at-scale value-based construct that has been somewhat successful. But most of the innovation in and around that has not been very successful. And that doesn't mean it's not going to get there at some point. Part of American ingenuity is trying and failing and trying and failing and trying and failing until you find a model that works.

And credit to those that are trying to do that. But it hasn't succeeded. Where I think there are opportunities that are more direct is modernizing where we perform healthcare services into a lower cost setting. That's direct cost savings. We built with the Hilbert Act all this infrastructure that is hospitals, okay? Let's point the figure at the industry that I'm most closely associated with.

And credit to those that are trying to do that. But it hasn't succeeded. Where I think there are opportunities that are more direct is modernizing where we perform healthcare services into a lower cost setting. That's direct cost savings. We built with the Hilbert Act all this infrastructure that is hospitals, okay? Let's point the figure at the industry that I'm most closely associated with.

And it has been happening. Some of that work is and could come out of hospitals into a lower cost setting.

And it has been happening. Some of that work is and could come out of hospitals into a lower cost setting.

I would give you the biggest example that has probably had the most impact on health status and colorectal cancer is that if you go back 20 years, most colonoscopies were done in a hospital setting. Sometimes people stayed overnight for them. Right. Just think about that. And they moved into an outpatient setting.

I would give you the biggest example that has probably had the most impact on health status and colorectal cancer is that if you go back 20 years, most colonoscopies were done in a hospital setting. Sometimes people stayed overnight for them. Right. Just think about that. And they moved into an outpatient setting.