Today, I had the great pleasure of attending an event sponsored by CHART, which is the parent organization of the Universal Healthcare Foundation of Connecticut. The event featured a discussion between Len Nichols of the Center for Health Policy Research and Ethics at George Mason University and Stuart Butler of the conservative think-tank the Heritage Foundation. The panel was moderated by the truly sublime Pat Baker, President of the Connecticut Health Foundation.
The discussion was remarkable for several reasons. First, both speakers are really brilliant, and they have a tremendous grasp on what's at stake in health reform. They said, as I have said over and over in the last two years, that the status quo is unsustainable. Health care costs are growing like mad. Insurance premiums are becoming an ever-greater portion of each American's budget. And exclusions of coverage of pre-existing conditions were (still are) causing too much hardship. Something had to give.
The speakers don't agree on many things from there on out; one is a liberal/progressive and one is a conservative. So one likes the public option and one doesn't. One thinks reform falls apart without the requirement that everybody have insurance because you need the healthy people in the pool to balance out the sick people, and the other disagrees. They both recognize that we have only taken a first step -- addressing coverage -- and that we still have to address cost. The way Len Nichols put it was helpful to me -- he said we need a realignment of incentives so that we can get a handle on cost. We have 1300 insurers in America, he said, and we probably need about 200 of them. And patients have to be given incentives to get the right care at the right time the first time. And we have to shift from pay for volume to pay for value. All of this is way more complicated than it sounds. But, as Dr. Nichols said, we have to do it because we can't keep going the way we're going. We simply don't have a choice.
What was perhaps the most remarkable thing of all, though, is that this was a completely civil -- indeed, humorous at times -- conversation by two people who have honest, good faith disagreements about how to fix the mess we're in. None of the name-calling, accusatory, demeaning, and disrespectful rhetoric we've come to expect when people differ on this issue. Nobody threw a book at anybody. Nobody called anybody a socialist. It was a reasonable and reasoned conversation between two very smart, well-informed gentlemen who both want the same thing: a healthier, financially sound America. It is only through this sort of bipartisan discussion that we are ever going to get this right.
All the people in America who are screaming at each other need to take a lesson from these two gentlemen. We have to be able to talk this through. Both Stuart Butler and Len Nichols provided an example for us all. Jennifer