HEALTH CARE REFORM--LET'S DO IT RIGHT!

January 16, 2017

I AM RE-POSTING A SLIGHTLY UPDATED VERSION OF A BLOG I ORIGINALLY POSTED OVER TWO MONTHS AGO. 

YESTERDAY, REPUBLICAN HOUSE LEADERSHIP AND PRESIDENT TRUMP HAD TO PULL BACK ON THE VOTE FOR THE REPUBLICAN DRAFTED REPLACEMENT TO THE AFFORDABLE HEALTH CARE ACT KNOWING THAT DESPITE ALL THE PRESSURE THEY COULD MUSTER, IT DID NOT HAVE THE VOTES TO PASS. 

ON THE ONE HAND, I AM GREATLY RELIEVED. THIS WAS PERHAPS THE POOREST CONCEIVED AND "CRUELEST" PIECES OF LEGISLATION I HAVE EVER SEEN. CITIZENS, REPUB LICANS AND DEMOCRATS ALIKE, TURNED OUT IN CONGRESSIONAL OFFICES IN HUGE NUMBERS TO PROTEST THE PROPOSED REPLACEMENT ACT. THIS HAS BEEN A CONFIDENCE BUILDING DEMONSTRATION THAT THE CITIZENS VOICE MATTERS WHEN IT IS FOCUSED ON A KEY ISSUE AND RELENTLESSLY ADVANCED. 

WHILE I AM, AS I SAY RELIEVED, EVEN MORE I AM SADDENED.

HERE IS YET MORE EVIDENCE THAT OUR POLITICAL PROCESS IS BROKEN. HEALTH CARE IS THE MOST COMPLEX OF ISSUES. IT HAS CONFRONTED OUR NATION WITH THE CHALLENGE TO FIND THE RIGHT WAY FORWARD NOT FOR YEARS, BUT FOR DECADES. IT REQUIRES INFORMED INPUT FROM HEALTH CARE AND INSURANCE EXPERTS; FROM EXPERIENCE IN OTHER COUNTRIES AND IN STATES IN OUR OWN. IT CALL FOR BI-PARTIANSHIP. WE KNOW THE ACA NEEDS TO BE IMPROVED AND SOON. WE KNOW OUR HEALTH CARE COSTS ARE TOO HIGH.

AS I SAID TWO MONTHS AGO, I SAY AGAIN, 

"SLOW DOWN, DO IT RIGHT, DE-POLITICIZE THE PROCESS" 

We have witnessed a furious political debate for the past six years about the Affordable Health Care Act. The debate continues today as Congress will decide how to replace and improve it. We are at a vital crossroads and we must choose the right path. The path we are on now promises more of the same: a politicized process that will continue to fracture the Nation and end up with a sub-optimum plan. It need not nor should it be this way.  

I start from the conviction that the legislation which will replace the ACA will have a greater impact on the everyday lives of the people of our Nation than ANY other legislation that will come before Congress in the next 4 years. We should act accordingly. 



My message is "slow down", "do it right", and "de-politicize" the process. 


The great majority of Republican and Democrats appear to agree on four key principles, all flowing from a joined conviction that ACA MUST be improved.

1. We should not cut back on coverage from that which has been achieved under the ACA.
2. The elimination of pre-conditions should be retained.
3. Costs should be reduced (we continue to have the highest cost without commensurate quality benefit).
4. We need to make it simpler for individuals/ families to get what they need. (A huge challenge). 

Let's get realistic.  Crafting a plan which will meet these principles is an enormously complex undertaking. There are a lot of ideas on the table but not one integrated plan, let alone one that has bi-partisan support. We should not be going ahead on a proverbial "gun to our head" time table. You can't get to the right plan in 30 -60 days especially with a new Administration coming into place. We have lived with ACA for years. Living with it for whatever few additional months are needed to get to the right next step is the right thing to do. 

Congress and the President's Administration should commit to achieve a plan that has bi-partisan agreement.The Democrats were roundly criticized for driving ACA through without Republican 
participation-- even though one should remember that President Obama tried for over a year to engage 
Republicans in developing a bi-partisan bill.

Be that is it may, health care has become the most sharply politicized issue during the past 6 years. It need not nor should it be that way.  Let's approach  this in a way that has the majorities of both parties working together.  It is the right thing to do. 


Action Proposal

1. Set the goal on both sides of the aisle of getting a bi-partisan plan which improves on ACA and take the time to do it. Set a reasonable but firm schedule.
2. Let the new Administration get in place including the new Secretary of HHS.
3. Form a bi-partisan Congressional Committee composed of Democratic and Republicans to come up with a plan that deals with the major issues with ACA which have been identified and which will have bi-partisan support. Bring the best expertise and learning to the creation of this plan: from health care and insurance experts; from experience in other countries and from the years of experience with the ACA.

We need to take the time to do this. To be sure, there will be controversy  surrounding any plan that emerges. There will be those on the right and the left who are unhappy with the final result. But we can and must reach a bi-partisan consensus based on a fact-based review of what are the key issues and how to best address them which will have the support of the majority of the citizens.


Our Nation is more divided than I have ever seen it. Trust has been eroded, including in Congress' s ability to work together to make good things happen. This distrust and frustration will be even greater now that the flawed Republican plan has not even been brought to a vote. 

The President and Congressional leaders should step back and take a deep breath, thinking only of how we go forward to get the best plan for the people of our nation we can.

They should put in place the process and take the time to craft a strong bi-partisan health care plan. Doing so will accomplish  two things.  

1. Get us to the the best possible plan.

2. Represent an enormous step to show we can de-politicize this process and work together for the common good. There are no magic bullets in changing the animosity filled climate that exists. However,  this would represent a defining step in the right direction.

In contrast, a health plan passed strictly on party lines will only exacerbate the current climate of division and resentment. We have seen that clearly over the last month. The other thing we have seen-- in the past week-- is that without bi-partisan support the legislation may not be passable in the first place given the split within the Republican party. 

Every major plan I was associated with in business didn't have it all right the first time. They all required changes. We now have six years of experience with ACA. We have identified things to be preserved and things to improve. We need to do this thoughtfully, taking the time needed to do it as best we can. It won't be the last change we make in our health care plans. But let's make it a smart change which has and deserves the support of the people (and their representatives) across the political spectrum. That's what  people of our Nation deserve at this critical moment of our history.  

4 comments:

  1. Well said John. We can only hope Washington will begin to listen.

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