The second keynote this morning was from James Mongan, MD, CEO of Partners Healthcare.

Within a few months there will likely be a bill signed on healthcare reform but Mongan believes that it will not have realised everything that was set out to be achieved. He asserts that the work on reform will continue for a number of years afterwards.

Despite the fact that there are huge numbers of uninsured, most still receive the treatment they need. What doesn’t happen though is that treatment for chronic conditions is not delivered in a preventative manner.

One proposal in the reform legislation is to introduce an Individual Mandate but Mongan asserts that this appears to be a new tax with another name. There may be restrictions on who actually pays this mandate but it doesn’t address the core need for insurance reform.

But what about the issue of controlling healthcare costs? Barriers to cost include the way costs are reimbursed and the lack of integration of the provider systems. With most items that you buy, you benefit immediately, but with healthcare payments you benefit later

It is likely that any new legislation will blend taxes, employer payments and individual payments but the key issue is the fairness of financing – who pays and how much? In Mongan's opinion, it needs to be a balance between individual liberty and justice for all.