Under the umbrella of the nonprofit America’s Agenda Health Care Education Fund, strange bedfellows have been exploring solutions through a series of summit conversations scheduled across the nation. Both of us have participated in these summits, the first at the University of Miami with President Donna Shalala as host. More recently, a summit was held at Washington University in St. Louis by former House Majority Leader Dick Gephardt (D-Mo.) and William A. Peck, director of the university’s Center for Health Policy, and another will be held May 6 at the University of California-San Francisco and hosted by Dr. Stephen L. Hauser, chairman of the Department of Neurology.
We are brought together by crisis. Already there is broad agreement that the nation’s deepening economic troubles make health care reform more critical than ever. Millions of Americans recently have lost their jobs and, along with them, their health insurance coverage. For every 1 percent rise in the nation’s unemployment rate, it is estimated that 1.1 million Americans will lose their health insurance.
Meanwhile, premiums for employer-sponsored health insurance have more than doubled over the past decade — far outpacing increases in workers’ wages and inflation over the same time period. This has made health insurance coverage increasingly unaffordable for businesses and working families.
Former Health and Human Services Secretary Shalala, at the first summit, perhaps expressed it best: "Our nation’s economic future depends on making the right policy choices on health care."
Mindful of the high stakes, summit participants are exploring not only ways to expand coverage, but how to improve the quality of health care and reduce health care costs. Those goals might seem mutually exclusive, but there is mounting evidence that a new consensus is emerging about ways to improve care and assure better long-term affordability.
One of the summit topics, for example, focuses on how to help Americans avoid illness. We know that 75 percent of all health care spending in the U.S. involves the treatment of chronic diseases such as cancer, heart disease and diabetes. Most of these diseases can be prevented by better habits, such as weight management through exercise and a good diet. This is no secret, but how can public policy effect change in a country where obesity is an ever-growing problem?
Current obesity trends are unsustainable: If they continue — to cite just one example — -one of every three children born in 2000 will face diabetes in his lifetime. In the last century, our nation met the mammoth public health challenge of preventing epidemics of infectious diseases that ravaged the population. In the 21st century, we face a comparable challenge of preventing an epidemic of chronic diseases that afflict scores of millions of Americans.
There is broad consensus about the need for early detection of disease — and productive discussion is under way about how our nation can achieve it. Again, to take just one example: Breast cancer caught in later stages costs four times as much to treat as breast cancer detected early. More important, of course, is the better outcome for patients.
No question: The guarantee of affordable, quality health care for millions of Americans who lack it will require a major national investment. Fortunately, agreement has already been reached to make a down payment on this guarantee with the federal investment of $17 billion to launch a national health information technology network that will provide much-needed linkage between hospitals and doctors’ offices. In the long run, we believe critically important investments in priorities like HIT, improvements in disease prevention, early detection and better chronic care management will not only greatly improve health care quality for all Americans, but will also reduce costs and improve worker productivity.
The principles for reform recently laid out by President Barack Obama closely mirror those being discussed at the summits: the need to provide Americans a choice of health plans and physicians; the need to reduce health costs for businesses and protect families from severe financial hardship, even bankruptcy, because of catastrophic illness; the need to invest in prevention; the need for coverage to be portable; the need to employ modern-day technologies to reduce duplication and improve coordination as patients see different doctors; and the need for quality coverage to be accessible to all Americans.
We are both very aware that fixing health care is good for patients, for families and for businesses, and it is an important component for reviving America’s economy. It won’t be easy, but it must be done. On that, we can all agree.
Billy Tauzin is president and CEO of the Pharmaceutical Research and Manufacturers of America. Joseph Hunt is general president of the Iron Workers International Union.