The health care debate is prompting some commentary on the dangers of a single-payer health plan.
That said, the private-sector system is sinking, prompted in part by the inability of politicians to act due to ignorance or self-interest.
Political success comes first from true political power or a case so compelling it must be approved. Yesterday, you would have laughed at the idea of placing “process” and real facts above sheer political power. Today, political power has come up empty, paving the way for a more considered approach to a topic that could bankrupt the country (see General Motors) and a last opportunity for years to do a deep dive into the entire health care system.
This involves a process that has a clearly stated goal and involves all stakeholders essential to meeting that goal, whose support strengthens political backbone to implement. It’s an organized approach to determining true needs to be met by a health care delivery and payment system that provides better and more efficient outcomes to everyone.
A significant problem in designing a program that will gain support from most Americans is the lack of expertise of those who make decisions on the broad workings of the nation’s health care needs, the delivery system and how these relate to personal costs, ability to pay, costs to employers and unions, costs to governments (national, state, local) and current best practices needed around the nation. In all, a formidable challenge to a group whose specialties are mostly elsewhere and who are charged with making life-and-death decisions.
The process outlined below seems challenging, overwhelming and raises questions on why we should go to all this trouble. The short answer is that without knowledge of all the critical issues of a subject it is almost impossible to make enlightened decisions and to develop a public following. We ask our legislators to do exactly this and provide them with little and likely fragmentary information to support their decisions.
We cannot educate them on all this overnight but we can reduce it to key considerations and have these presented in a manner that is easier to absorb. That is what this process is intended to facilitate:
1. Appoint a knowledgeable, powerful, respected person to be chairman of the project and who reports directly to the president.
2. Set aside all preconceived notions of what the plan should contain and how it should operate. They can be addressed later.
3. Develop a broad goal against which all stakeholder presentations can be measured — a system that ensures availability of health care services to all Americans and provides government funding where essential.
4. Emphasize clear goals for health care outcomes, disseminating best practices and identifying funding needs.
5. Identify all stakeholders in health care and have each provide one representative, likely from their national associations or central authorities. Those would include doctors, hospitals and health care delivery organizations, emergency services, pharmaceutical companies, large employers, small businesses, national unions, medical equipment and device manufacturers, medical education providers, and medical liability lawyers. Also included would be insurance companies wanting to be in the health insurance business; governments (national, state, local) including professional licensing and insurance regulating agencies; volunteer organizations and representatives of people in need; specialists to identify clear areas for government support, and others not noted above.
Each representative’s responsibility is to present a summary report of issues of essential concern to his or her stakeholders and what the public would expect to be preserved, to be presented to the chairman.
Have a knowledgeable commission, reporting to the chairman, summarize each stakeholder presentation into a format that will help legislators understand the essential issues against which they could evaluate their legislative proposals. (The commission may or may not develop an actual plan. That is Congress’ responsibility.)
Hold a symposium in which these summaries are presented in a professional manner so that all legislators hear the same information from the same presenters at the same time. Afterward, have these representatives available to legislators and aides, a paid job reporting to the chairman.
Beadle, of the Imagine Solutions Conference in Naples, was chairman, C. Everett Koop Awards; director, Security Mutual Life Insurance Co.; former chairman of American Benefits Council, U.S. Chamber of Commerce Health Committee and Business Forum on Aging.
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