Key milestones in government shutdown fast approaching
The ongoing government shutdown may disrupt paychecks, Head Start programs and healthcare subsidies by November.
When a system keeps breaking in the same places, there comes a time when you need to stop patching and start redesigning. That’s where our health care system in Michigan is today.
For decades, we’ve relied on a model that pours billions of dollars into treating illness after it occurs, often through high-cost crisis care, instead of sustaining health at every stage. Each time costs rise, we apply a temporary fix: a new program, a one-time funding bandage, a targeted cut. And the same problems return.
Over my more than 45 years in health care (I became president and CEO of Henry Ford Health in 2022), I’ve seen how this approach leaves patients and caregivers frustrated. We can do better. And Michigan can lead the way if we take the initiative to do what’s right ― not just what’s easiest.
We also know that world-class care for complex conditions, the kind our clinicians have provided for over a century and will be able to do at an even greater level when our Destination: Grand tower opens in 2029, is vital to a strong, equitable system. A redesigned model must do two things: prevent the illnesses and injuries that we can, and provide the most advanced, life-saving treatments when prevention isn’t enough.
Here’s where we start
Redesigning Michigan’s health care system starts with five core principles:
- Invest where health begins. Rebalance funding toward primary care, behavioral health and community-based services, including fair Medicaid reimbursement, so prevention and early intervention are accessible to everyone. Because Medicaid reimbursement levels are set by the State of Michigan, aligning those rates more closely with the real cost of care would strengthen health systems’ ability to invest in prevention and early intervention, helping patients receive care before it becomes a crisis.
- Reward prevention, and high-value care. Align incentives so providers are paid for keeping people well, and for outcomes when people are ill.
- Rebuild the ecosystem together. Bring hospitals, payers, employers, pharmaceuticals and policymakers to one table to design a coherent system, rather than a patchwork of competing interests. We’re already laying the groundwork for a health care affordability roundtable in 2026 to begin confronting this challenge directly.
- Make Michigan a leader in health care transformation. Develop and test new statewide health care models that bring together hospitals, insurers, employers and policy makers, which could serve as blueprints for the rest of the country.
- Propel innovation. Continue advancing AI, digital access and precision medicine, while using them to lower costs and improve quality of care.
Only 5% to 7% of U.S. health spending goes to primary care, compared to roughly 14% in nations that achieve better outcomes and where people live longer lives. Here in Michigan, Medicaid reimburses hospitals at a rate of about three-quarters what Medicare pays for comparable services, placing our state in the bottom half nationally in reimbursement levels. The result: Hospital systems, including Henry Ford Health, are treating patients in crisis rather than minimizing crises in the first place.
We see the effects across our state. Rural hospitals are closing vital services like birthing centers. Employers face unsustainable benefit costs that threaten their competitiveness. Families delay care until problems escalate. Michigan ranks 31st in per-capita health care spending and below most states in life expectancy. Our health reflects our current system, which has for the most part rewarded volume instead of value.
We can do better
At Henry Ford Health, we’re already testing what redesign looks like. New technologies, including AI-enabled tools, are helping physicians spend more time with patients and less time behind screens. Our digital “front door” gives people more confidence and control in choosing where and how to get care, guiding them toward lower-cost, more appropriate options earlier.
And for patients with the most complex needs, we’re innovating to deliver the best possible outcomes ― through advanced procedures, precision medicine, and multidisciplinary teams that manage both quality and cost. Equally important, we partner with community organizations to address social determinants of health, like food and housing insecurity, which is essential to the health and wellness of the communities we serve.
These aren’t patches; they’re prototypes for a system that combines human connection with smart technology to make care more personal, proactive and accessible.
Real reform requires the right mindset: seeing how the parts connect, aligning incentives and creating a system that works better for the people it serves. Improved outcomes and cost savings will follow when we stop waiting until people need crisis care, and instead focus on helping people achieve and maintain good health.
This isn’t a call for more bureaucracy or socialized medicine. It’s a call for courage and coordination. We need collaboration among employers, providers and insurers, and bipartisan governmental support, to rebuild the system so it delivers on the “health” part of “healthcare.”
Michigan can lead that effort. We can show what it looks like to link compassion with economics, prevention with productivity, and innovation with access. Because the real question isn’t whether we can afford to redesign the system into one that promotes prevention and delivers excellence in every form of care. It’s whether we can afford not to.
Bob Riney is president and CEO of Henry Ford Health. Submit a letter to the editor at freep.com/letters, and we may publish it online and in print.
Want our sharpest, most relevant takes delivered straight to your inbox? Subscribe to Freep Opinion’s free, weekly newsletter.