Patience Is A Virtue

A full 190 days ago, when President Obama entered office, the time from the Inauguration until the August congressional recess seemed more than adequate to come up with sweeping health-care reform legislation, especially with a democrat-controlled Congress at the helm. And yet, here we are, on the cusp of the August recess, witness to a house divided, and no clear consensus. Thankfully, moderate members of President Obama's party have taken heed of the warnings coming out of the Congressional Budget Office - that currently-proposed legislation breaks the bank - and have asked for a "time out" to reassess whether or not they've truly thought this health-care reform thing through. There's a collective feeling of being a bit rushed at the moment...

As my Wisconsin colleague, John Torinus, points out, the financial incentives currently proposed in the House-passed legislation do not fix the problems of skyrocketing costs but actually make them worse. The penalties for individuals and businesses that chose to opt out are actually no penalties at all, but the path of least resistance. What business owner wouldn't opt for an eight-percent payroll "penalty" when they're already covering their workforce, on average, for twice that amount? Where's the consumer focus? Price transparency? Outcomes? When will we move away from buying piecework sick-care and instead buy a healthy, productive populace?

The August recess deadline is artificial. Let's take our time and get health-care payment reform done right - in a way that fosters health-care delivery transformation along the lines of the Institute for Healthcare Improvement's Triple Aim: cost-effective access for all, within a delivery model that provides a superior experience of care, and in a way that markedly improves measures of population health.

Sometimes a little time away from work gives one a sense of perspective. My wish for the members of congress is that they take their much-needed August recess, and use the time to re-charge their mental batteries. When they return from vacation, perhaps they'll be more inclined to pass a pared-down piece of legislation. It seems to me that the correct federal role should be to craft the general framework for health-care payment reform such that it vests the responsibility with the states to flexibly innovate in health-care delivery transformation.

Senator Baucus, chairman of the Senate Finance Committee has delayed the release of his group's legislation, expected by many observers to be the definitive health-care reform bill. We can only hope that by investing the extra time and energy it does a better job of fostering the sort of fixes that will actually reduce health-care's drag on the U.S. economy. Patience is, after all, a virtue.

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Raymond J. Zastrow

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Patience Is A Virtue