Rushing Healthcare Legislation Through Without Consensus

I belong to a terrific organization that brings together C-level executives, once a month, to discuss issues each of us face.  It’s called Vistage.  One of the subjects we talked about yesterday was health care.  It was like a focus group made up of seasoned, senior executives from many different industries.

The discussion revealed the tremendous divide between what ordinary Americans think about health care and what policy makers in Washington are doing.  It’s a combination that is almost certain to ensure that whatever reform passes may make our problems worse, rather than better.

At the meeting were about 30 executives, representing everything from financial services, commercial real estate, manufacturing, high technology, pharmaceuticals, insurance, retail, non-profits, travel and others.  Although all thought health care costs were in a state of crisis in America, I did not hear anyone say this was the case in their business.  To be sure, some complained that health costs were high, and that there were few alternatives available.  But others described changes they had made to their plan designs that had actually reduced their corporate health expenses.

We talked about the proper role of government, the comparative worth of systems in other countries, the responsibility of people to take care of their own health, end-of-life care, over-treatment, the uninsured, access to care, comparative effectiveness, and our own expectations of what the system should do for all of us.  There was no consensus among this group of 30 business leaders as to these subjects and what we should do about them, other than that they are important topics that we need to address.  I suspect this is true outside of this group, too.  Indeed, the huge collection of issues that fall under the category of health care reform is something I’ve pointed out before.

But the President and leaders in Congress want debate on health care to end.  They want a a bill to pass in the next couple of weeks.

Most of the group members were surprised to hear that Congress had already drafted legislation and was getting ready to vote on it.

It’s a remarkable thing.  We are in the midst of trying to redesign the largest health care system in the world, and we’re barely debating the merits of it.  How many members of Congress will have read the 1,1018-page bill once they vote on it?  How many Americans will understand what implications it has for their health care if it — or something like it — becomes law?

The President often says that the status quo in health care is “not an option.”  The trouble is, the status quo in health care is a rapidly changing thing.  Today, every day, employers and doctors and so many others are busy making real, meaningful changes to our health care system.  Not by waiting for committees of Congress to pass legislation, but by getting together and doing things that improve the quality and cost of care and the lives of patients.  We need to be listening to their stories, and learning from them.  Congress hasn’t done this, and can’t now.

There is an opportunity to build a real consensus around the important issues we talked about yesterday.  We can transform our health care system in ways that make all of us proud.  But it can only happen by working through these hard questions, not by hurrying to pass a bill before the August recess.  Those who say we have a once in a generation chance to reform health care today may be right, but not for the reasons they think.  By passing bills without consensus on this deeply important and emotional issue, they are ensuring that no one will really want to try to reform health care again for a very long time.

Which leaves us very much where we started.  I will continue to do my part to share the important stories of how real people are making real reform.  The political attention to reform may end sometime this year, but the reality of people trying to figure out what to do when sick will continue.

*This blog post was originally published at See First Blog*


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