Health System Can Be Mended

January 27, 2009 - The Miami Herald
By Donna Shalala

Our broken healthcare system is bankrupting people and businesses. We're all paying a lot more and getting less. Our nation's economic future depends on making the right policy choices on healthcare.

We must stem the growing costs of healthcare, and if coverage is not nearly universal, large costs will continue to be shifted to the insured. Yet our country has never taken a giant leap in any major social change without agreeing that a problem exists and how to solve it. Small steps help, but larger changes are necessary, and we'll need consensus to take them.

Our healthcare system needs major changes, but there's no political agreement about what should be done. There is hope, to be sure, and optimism that the Obama administration and a new Congress will act quickly on healthcare, because it is a fundamental element of the nation's infrastructure that needs repair. 

Reform campaigns

Exploring a newly emerging consensus for healthcare reform is precisely the purpose of a series of ''Summit

Conversations,'' sponsored by The America's Agenda Health Care Education Fund. The first is on Wednesday at the University of Miami, and I am honored to serve as host. Participants include former U.S. Rep. Dick Gephardt, medical experts, business leaders and presidents of international labor unions.

America's Agenda is a unique organization in the fight for affordable, high quality healthcare for all. It has an

unrivaled record of building and strengthening comprehensive healthcare reform campaigns in states across the country. I share their conviction that Massachusetts, Vermont and some of the other states struggling to solve this issue offer important lessons for the rest of us. Social Security, Medicare, children's health reform, welfare reform -- we built them off of state experimentation. We learned from what people were trying to do on the ground.

From their experience in state health reform campaigns, those at America's Agenda believe a national consensus is emerging that should be a valuable guide and motivator to the new Congress in drafting needed legislation. America's Agenda has built broad-based campaigns in Vermont, Illinois, Maine and West Virginia, and it has won landmark gains by finding common ground among labor, business, leaders of both parties and others who were implacable adversaries in past reform efforts.

The Summit Conversations commence at an opportune time. Recent polls show three-quarters of Americans expect major healthcare reform legislation to be passed in President Barack Obama's first term. Democratic leaders in Congress are reaching across the aisle for bipartisan support, and there are promising responses from business and labor.

The Summit Conversations will focus on identifying healthcare cost drivers, disease prevention, chronic disease management, care coordination, restructuring patient and provider incentives, improving health information technology and affordable access to all -- issues around which consensus is emerging in the states and nationally among leaders who were not always in agreement.

The Summit Conversations will examine that consensus, determine whether it's durable and probe its limits. Paul Krugman, a professor at Princeton University and New York Times columnist who recently received the Nobel Prize in economics, wrote that ``the history of the pursuit of universal health care in America is one of missed chances and political opportunities.''

That is a somber warning for those of us who've spent a lifetime working for reform at a time when so many

promising signs indicate that the moment is now. Healthcare reform is not a done deal -- not yet. Many diverse constituents must take responsibility for it to happen.

Work in unison

Success depends on the large purchasers and healthcare stakeholders, including those with insurance, doctors and hospitals, nurses and insurance companies and labor unions -- everybody with a stake in the current system -- and whether they're prepared to take a step forward.

It will take leadership to bring them together, but not just presidential leadership. It will take leadership from a Congress deciding that it wants to do it and is willing to work with the president. It will take leadership in the many diverse sectors of American society represented in the Summit Conversations.

''Missed chances and political opportunities''? Not this time. Too many lives depend upon achieving our long- awaited goal of affordable, high quality healthcare for all. 

Donna Shalala is president of the University of Miami and served eight years as secretary of Health and Human Services during the Clinton administration. Last June she received the Presidential Medal of Freedom, the nation's highest civilian award.

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