Observation Deck: The Time’s Right

Healthcare is as intractable an issue as the weather; no one agrees on how to fix it. Indeed, there are some who don’t believe it even needs fixing. But I sense that may be changing. Maybe it’s the fact that more than 40 million Americans — most of them from families that have at least one worker — now lack health insurance. Maybe it’s the fact that those who have insurance are watching their premiums rise much faster than the rate of inflation — with no end in sight. Maybe it’s the fact that employer-subsidized healthcare benefits are evaporating faster than a Popsicle on a summer sidewalk (to use the words of Oregon Senator Ron Wyden in this month’s “Executive Interview”). Many of the presidential candidates have come out with a plan; so has AdvaMed (the association for medical device manufacturers) and the American Hospital Association (in conjunction with the American Medical Association, Blue Cross and Blue Shield Association, and others).

In some ways, today’s growing interest in healthcare reform reminds me of the tale of the boiled frog, which we’ve all heard during countless motivational speeches. I don’t know if it’s true or not, but they say that if you toss a frog into a pot of boiling water, it’ll hop right out. But if you put a frog in a pot of cold water, then slowly bring it to a boil, it’ll get boiled to death. Similarly, were any of us to be introduced to a society in which 14 to 15 percent of the population lacks health insurance and in which as much as 17 percent of the gross domestic product is spent on healthcare, we might be alarmed. But that is indeed the society in which we live today.

It’s true that, we have de facto universal coverage, inasmuch as an uninsured person can walk into any hospital and get emergency care. But, says Wyden — and a growing chorus of others — it’s an inefficient and expensive way to take care of people, particularly if primary care is being provided in the emergency room. And it’s not a particularly nice system either. Let’s face it: Nobody wants to lie awake at nights worrying about losing his or her family’s health insurance because they’ve been laid off or because they face a layoff.

Could it be that the time is finally right for comprehensive healthcare reform? Wyden believes it is, because enough sectors of the economy — big employers, unions, insurers and providers — are concerned that if we maintain the status quo, we’ll all boil to death. But translating that concern into action is another matter. For true reform to occur, we’ll all have to put aside the rhetoric. When asked what the biggest stumbling block to comprehensive healthcare reform has been, Wyden says “scapegoating.” Republicans blame big government, Democrats blame big pharma and insurance companies.

Beyond the name-calling, there appears to be consensus among key players in the debate on the following points: 1) that it’s better economically and socially for all Americans to be insured; 2) that preventive care can help cut costs; 3) that consumers should be able to pick their insurance plans; and 4) that to some extent, individuals should be held responsible for taking care of themselves.

By building on these points, Republicans, Democrats and all others just may have their best shot at improving our healthcare system.

About the Author

Mark Thill
Mark Thill is the Editor of The Journal of Healthcare Contracting and has been reporting on healthcare supply chain issues since 1985. He is a graduate of Dominican University in River Forest, Ill., and he received a master's degree in journalism from Northwestern University in Evanston, Ill.