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Q&A

J.K. Wall
December 9, 2009
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Dhan Shapurji, an Indianapolis-based health care consultant for Deloitte, advises hospitals, health insurers and others on how to meet looming challenges and opportunities in the health care industry. He discussed the potential impact of health reform bills pending in Congress.

IBJ: What will be the most significant change to the health care market if the Senate health reform bill goes into effect as-is?

A: The inclusion of 30 million more folks. That is the most significant change. The ramification of bringing in those 30 million plays throughout the whole system. Insurance reform as well: It has been the area that has gained the most attention. The individual mandate, the potential for an employer mandate, but also what will happen with the benefit design. All of those are very tangible things that consumers will feel and see out of the reform that goes through.

IBJ: Which parts of the health care industry will be the biggest winners under health reform, and which will be the biggest losers?

A: The hospitals and the provider community will fare well underneath this scenario, perhaps relative to other players, primarily because you have an influx of customers into the system. Hospitals will get relief on the bad debt. But the influx of more people into the system could create supply issues. The one issue of uncertainty is the cost area. Certainly, utilization going up has the potential to raise costs throughout the system. It may put pressure on state governments because, as you know, their budgets aren’t exactly in the best shape today.
 
IBJ: You've said before that the big health care problem in the United States is the tens of trillions of dollars in unfunded commitments under the Medicare program, which is projected to become insolvent by 2017. Are there elements in either the House or Senate health reform bills that would improve that long-term situation?

A: What we see in the legislation today doesn’t really directly do it. It’s really focused on "How do we bring the 30 million into it?" rather than "How do we make Medicare solvent?" The changes that need to be made are pretty darn significant. One of the changes is perhaps taking [the minimum age for Medicare eligibility] up to 70. Another one suggested is means testing [where wealthier recipients would pay more for Medicare benefits]. And another one that’s being talked about is raising the payroll tax. I think, personally, it’s going to take benefits changes, and some combination of the others.

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  1. I had read earlier this spring that Noodles & Co was going to open in the Fishers Marketplace (which is SR 37 and 131st St, not 141st St, just FYI). Any word on that? Also, do you happen to know what is being built in Carmel at Pennsylvania and Old Meridian? May just be an office building but I'm not sure.

  2. I'm sorry, but you are flat out wrong. There are few tracks in the world with the history of IMS and probably NO OTHER as widely known and recognized. I don't care what you think about the stat of Indy Car racing, these are pretty hard things to dispute.

  3. Also wondering if there is an update on the Brockway Pub-Danny Boy restaurant/taproom that was planned for the village as well?

  4. Why does the majority get to trample on the rights of the minority? You do realize that banning gay marriage does not rid the world of gay people, right? They are still going to be around and they are still going to continue to exist. The best way to get it all out of the spotlight? LEGALIZE IT! If gay marriage is legal, they will get to stop trying to push for it and you will get to stop seeing it all over the news. Why do Christians get to decide what is moral?? Why do you get to push your religion on others? How would legalizing gay marriage expose their lifestyle to your children? By the way, their lifestyle is going to continue whether gay marriage is legalized or not. It's been legal in Canada for quite a while now and they seem to be doing just fine. What about actual rules handed down by God? What about not working on Sundays? What about obeying your parents? What about adultery? These are in the 10 Commandments, the most important of God's rules. Yet they are all perfectly legal. What about divorce? Only God is allowed to dissolve a marriage so why don't you work hard to get divorce banned? Why do you get to pick and choose the parts of the Bible you care about?

  5. Look at the bright side. With the new Lowe's call center, that means 1000 jobs at $10 bucks an hour. IMS has to be drooling over all that disposable income. If those employees can save all their extra money after bills, in five years they can go to the race LIVE. Can you say attendance boost?

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