Avoid Analysis Paralysis!

My first thought when reading this week's inaugural question was: impossible to answer! Too many moving parts. Too many stakeholders to bring aboard. Too many problems to fix, most of which are so deeply intertwined that attempting to fix them one at a time would result in too many missed opportunities.

Thus, after my own three day "analysis paralysis," I conclude that there cannot be a "first." We need a multi-tiered, simultaneous and thoughtful approach to reform.

First, one must remember that government is not stepping into this area because of paternalism or a lack of other priorities. Our federal, state and local governments are already deeply involved in the delivery, financing and regulation of health care. We already spend more from public sources alone (i.e., tax dollars) on a per capita basis than any other country, including public and private contributions. Ensuring that this spending (which is more than $1.2 trillion dollars annually) is productive (improving health, not just paying for low-value or no-value health-care) is a responsibility of our elected officials. On that basis alone, one should argue for payment reform from our largest federal program--Medicare.

Second, public goods will be under-provided in the market unless a public entity steps in. In this case, information about comparative effectiveness is quite clearly a public good. And while the stimulus bill has provided for initial financing of such research, it needs a sustainable financing stream and an infrastructure.

In order to pass and not just debate such legislation, we need broad stakeholder support. This must include physicians, facilities (acute and non-acute), health plans, pioneer and generic drug companies, biotechnology and medical device firms, important supporting personnel (including physician associates, nurses, and other health-care professionals), supporting technologies, the many providers of logistical support and the patient advocacy community (which understandably is concerned about wholesale change). Each has something to gain from any effort at extending health insurance to the 50 million who are uninsured; each must be engaged and committed to "bending the curve" so that future costs will be sustainable.

Our approach to reform must embrace our national priorities: eliminating the problem of the uninsured; making our spending sustainable for employees, employers, and the government (taxpayers); and a willingness to make mid-course corrections if and when we find that aspects of the plan are not perfect.

By Howard Forman  |  June 11, 2009; 1:57 PM ET  | Category:  Health Care Reform , Insurance , Medicare , Prescriptions
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Posted by: STANTONCAROL | June 14, 2009 8:32 AM
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