Julie Appleby, USA Today, moderated this panel and asked each member to give a three-minute solution to health reform.
David Himmelstein, a promoter of single-payer government health insurance, is a primary care M.D. in Cambridge, Mass. He says we need to reform the insured as well as the uninsured. He says by spending what we currently spend on health care more wisely (31 percent for administration.) He says $80 billion insurance overhead would be eliminated.
Karen Davis from the Commonwealth Fund has five principles: Coverage for all, payment reform, a more organized health care system (a “medical home” that ensures access, not just coverage), narrowing the variation in quality and efficiency and bringing everyone to the highest level of quality, national leadership with the private and public sector working together.
Julie Barnes from the New America Foundation’s Health Policy Program has a mission to “preach hope and dispel fears.” She urged journalists to include solutions in their reporting. Their goals: cover all Americans, reduce costs and improve quality. She says these are inextricably linked. Covering everyone means we need to change how we pay doctors, paying not for quantity but quality. She says it can’t happen without bipartisan support, and that we need to encourage conversation.
Tom Miller from American Enterprise Institute says we need to introduce incentives that move us toward a sustainable, value-based health system. We need to encourage healthier behavior by consumers. More emphasis on primary prevention. He says he will “revise and extend his remarks” on the AEI web site.
The Davis/Commonwealth proposal sounds a lot like what the Mayo Clinic Health Policy Center has been advocating. Many of the principles are similar.
Miller says the mismatch between what we spend and what we receive is the fundamental problem. We can’t tax ourselves enough to pay for a program when overall costs are increasing faster than the economy.
Miller and Himmelstein got into a discussion that was, at the very least, “spirited.” Julie Barnes got her wish for “conversation,” I guess.
Julie Appleby asked each of them to suggest story ideas for the assembled journalists. Their suggestions:
Barnes: Write about how we cannot “not” afford health reform.
Miller: Why is it that by shifting costs we make them go away? Why are things a better value when we pay for them collectively?
Himmelstein: Suggests doing profiles on members of his organization (he says there is one in virtually any community), who support a national single-payer program.
Davis: How different prices are charged to different kinds of patients for the same drug or device. Also suggests looking at success stories and calling attention to programs that are keeping people out of the hospital.
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