Detroit executive travels to Madrid to understand Spain’s flourishing national health care system

Linda Alexander in Mad_optLinda Alexander, chief clinical officer of Total Health Care, a Michigan Managed Care Plan, has learned in her more than 20 years as a health care executive that broadening her perspective on American health care by looking beyond U.S. borders allows her to strike a delicate balance between the human connection and complex business aspects of health care management.
That is a smart and much-needed approach in this time of uncertainty as the Affordable Care Act remains under fire. On Nov. 10, the Obama administration predicted that the number of people with health coverage through the Affordable Care Act’s insurance marketplaces will be significantly lower by the end of next year than previous government estimates.
During midterm elections, several Republican senators won Senate races in which they emphasized opposition to the health care law, as did successful Republican House candidates.
Alexander understands the ongoing opposition to the Affordable Care Act, yet this Detroit native’s goal is simple — to be a beacon of light by positively influencing modern health care to benefit all Michigan citizens, especially those in underserved communities.
Alexander, a sought after speaker by state and national health care organizations, traveled to Madrid, Spain this fall as a delegate for the TPG International Health Academy Spain Executive Trade/Study Mission. While in Madrid, she gained a greater understanding of a successful national health care model — which virtually all of Europe has — and its impact on the population.
Her objective was to bring key insights back to the Detroit area where she develops population health management strategies, provides perspective on care integration and is responsible for Total Health Care’s clinical operations and population health management of 120,000 members who reside in Wayne, Macomb, Oakland and Genesee counties.
“Spaniards are engaged, well informed and very proud of their country’s health care system, and government contracts with health care companies are based on the best interest of Spain,” said Alexander. “Learning about Spain’s national health care system gave me a greater appreciation for my home country, which I love, but it also pointed me to economic and social factors that may be contributing to our health challenges.”
Alexander, along with other US delegates, visited Madrid’s Hospital Rey Juan Carlos Móstoles where they met with physicians. During her visit to Spain where delegates also met with government officials, she observed the Spanish government’s efficient process of handling costly administrative functions, from negotiating contracts to selecting vendors.
By comparison, the United States maintains a decentralized system, relying on varied resources to manage patient services, including verifying patient insurance and obtaining payment authorizations.
“These administrative layers are non-existent in Spain,” she said. “Patients carry health care cards used for registration for care, prescriptions and scheduling appointments.”
The Spanish government sustains health care costs that are one-third less than the U.S. Their national health care system maintains control over pharmaceutical and technological adoption. Committees evaluate contracts, negotiate pricing to distribute power equitably and maintain objectivity.
A current health care problem the United States faces is the cost of new drugs to treat hepatitis C. The Centers for Disease Control estimates that approximately 3.2 million Americans are chronically infected with the hepatitis C virus, with an estimated 8,000 to 10,000 hepatitis C virus-related deaths annually.
“One pill can cost $1,000 or $80,000 for a course of treatment of the hepatitis C virus,” said Alexander. “In Spain, they are weighing the cost vs. benefit ratio of bringing this drug to their market. If brought to market, the drug company must agree to negotiated pricing, which will likely be substantially lower than in the US. Some might call this rationing of care. I say it depends on your perspective. It works for Spain and the citizens appreciate it.”
Alexander, a mother of three, is a respected business leader and community servant. She volunteers her time and talents locally as a member of the Renaissance (MI) Chapter of the Links, Incorporated and the Detroit Alumnae Chapter of Delta Sigma Theta Sorority, Incorporated.
She sits on several boards, including Neighborhood Service Organization and the American Heart Association of Southeast Michigan, Delta Service Through Detroit Foundation, Inc. and community advisory councils including Association of Community Affiliated Plans (ACAP) Strategic Advisory Board, and Michigan Health Council’s Education2Practice Program.
Linda Alexander continues to serve as a leader in the health care industry, constantly pursuing ways to bring greater clarity to the ever-changing American health care landscape and to deliver optimum services in this era of health care reform.

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