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A panel of medical and insurance experts discussed trends in health care at a Des Moines Business Record Power Breakfast last week, and talk focused on two topics: how consumers can find the care they need, and how they can avoid needing care in the first place.

“Employers in the Midwest are leading the nation in terms of offering consumer-driven health plans,” said Leonard Grover, a principal at Mercer Health and Benefits. However, “Iowa employers are not leading in providing information to employees about the quality of health-care providers.”

Grover said the health maintenance organization era “taught us to be spectators” who didn’t consider variations in quality among hospitals, for example. Now the insurance industry has gone to Health Reimbursement Accounts and Health Saving Accounts, and Grover said, “People spend their own money more wisely than someone else’s.”

Along with Grover, the panel at the June 10 event included Eric Crowell, president and CEO of Iowa Health – Des Moines; Tom Evans, president and CEO of Iowa Healthcare Collaborative; Steve Flood, senior vice president at Holmes Murphy & Associates; and Joe LeValley, a senior vice president at Mercy Medical Center. Dean Borg, a senior producer and public affairs reporter for Iowa Public Radio, served as the moderator. About 200 people attended the event.

Flood took a different focus than Grover, emphasizing the diseases that people bring upon themselves. “We’re producing disease at such a rate that the system cannot sustain itself,” Flood said. He cited the extraordinary rise of diabetes in America, much of it caused by obesity.

When we talk about rising health-care premiums and compare hospitals, he said, “We’re picking dead fish out of the stream. We never go upstream to find the causes.”

Evans agreed, saying that with today’s generation of obese children, “we’re building diabetics; we’re building joint replacements.” He noted Iowa’s high ranking in medical care but added, “Our state ranks 45th to 50th in physicians per capita, and recruiting doctors to come here is very difficult. What happens to quality health care in an access-challenged state?”

The panel dealt with relatively few specifics, but LeValley described a Mercy program that used nurse care managers to monitor congestive heart failure patients after they leave the hospital. He said readmissions were reduced by 88 percent.

However, Crowell said, “If we continue to focus only on the hospital piece” of the puzzle, “we will have failed. That’s where employers can make a difference.”