With so many people weighing in on the topic of health care reform, actuaries have added their voices too.

The Society of Actuaries' Health Section has published a collection of 29 essays from actuaries, health care professionals, and academics titled Visions for the Future of the U.S. Health Care System. The essays cover a wide array of health care issues, but there are four underlying topics:

• general reform and restructuring of the health care system
• risk pooling and risk-adjusted payments
• evidence-based medicine
• more efficient cost/care

Each of the 29 essays supports one of these four key angles and emphasizes the roles that actuaries can play with health care reform.

"Through access to more robust data, actuaries can help analyze the feasibility and long-term sustainability of proposed plans," said Jennifer Gillespie, chair of the Society of Actuaries' Health Section. "That insight can help aid in understanding where the past problems were and how to best mitigate these risks in the future."

In an essay on general health care reform, David Axene, president of Axene Health Partners LLC, brings attention to the need for general reform to include the entire U.S. population, not just those with health care insurance, to help bring balance between spending and debt. "Everyone's cost to obtain health coverage should go down if more people are covered by some form of a health benefit plan just from the reduced write-offs of health care providers," he wrote.

Thomas Persichetti, consulting actuary at Persichetti & Associates, LLC, tackled the subject of new ways to pool risk within health care. "The question should be asked, is it possible to restrict the role of health insurance to only those individuals that meet the definition of an insurable risk?" he wrote. "... One possible solution is to establish a national high risk pool and enroll everyone with one or more chronic conditions in it."

In his essay on the need for evidence-based medicine, John Cookson, consulting actuary at Milliman Inc., discussed how consumers must be more responsible for their own care, but be given the tools and information they need to make wise choices. He also urges providers to become more efficient and improve quality of care. Cookson's arguments support the overall need for results-driven medicine and procedures, which is a similar approach to risk management for corporations.

Writing about the need for more universal access to data, Dale Yamamoto, president of Red Quill Consulting, stated in his essay, "Creating a national data warehouse will facilitate the ability for actuaries and other analysts to have access to more consistent data from all health plans to better understand their ability to manage health care utilization."

In conjunction with the release of the essays, the Society of Actuaries conducted a survey of its health actuaries to gauge their thoughts on health care affordability, access, and quality. Out of nearly 300 survey respondents, 39 percent believed that one of the most important roles that actuaries can play in the health care debate is to invest in quantitative research to quickly evaluate proposals for reform.

The other key findings from the SOA health survey include:

• The highest priority in addressing the issue of health care quality, said 34 percent of respondents, is on comparative effectiveness and evidence-based medicine practices being implemented by all providers. The second highest response was on the need to align provider reimbursement with outcomes.
• Requiring Americans to buy health insurance was the top priority (33 percent) in terms of health care access, followed by the need to make all insurance portable.
• Nearly 40 percent of respondents believe the top priority in terms of managing health costs is aligning reimbursement for providers with efficient use of health care resources.
• Maintaining affordability of insurance is where employers need the most help in providing health care to workers, according to the survey respondents.

"With our expertise and rigorous training in risk management, insurance and longevity, actuaries are well-equipped to work with key stakeholders in finding a new viable solution for the challenging health care crisis," Gillespie said.