A way forward on health care reform

Sometimes to move forward, you need to take a step back.

Maybe it’s time we as a country candidly acknowledge our deep divisions on health care policy and work to develop a framework on the fundamentals on which we can agree. I don’t believe we will ever get to sustainable, comprehensive reform strategies without a bipartisan approach. Not bipartisan in the purely political sense but working together in a spirit of inviting diverse viewpoints, underscored by the tenet that health care is at its core about people, not CBO figures.

Health care affects each one of us as individuals, along with our families, colleagues and employees, friends and neighbors. It’s deeply personal. In today’s climate, it’s easy to be lulled into either a sense that health care is just another partisan game of hot potato or that it’s just too complicated to understand, so someone else can figure it out. In fact, it belongs to each of us, and we all should have a voice in reforming it — as employers, as consumers, as family members and as community leaders.

You might now be thinking: “Of course, you care. You run the state’s largest health care organization. You’re not only knee deep in the issue but also have the most to gain or lose.” On point one, yes. On point two, we all have skin in this game.

Nothing could be more devastating for a family than medical bills that are out of their financial reach. We know that for many businesses, health care premiums are still too costly, and for small businesses, a serious health event with only a few employees can make insurance costs untenable. Not only is health care personal, it comprises about one-fifth of our national economy. We spend enough on health care in this country; it’s time to assert that we deserve better value for the dollar and be able to draw a straighter line between our health care investment and a healthier population. We cannot do this now.

In a white paper I wrote several months ago titled “The Time is Now for Real Re-

form,” I suggested that we need an approach that indeed is bipartisan, combining concepts from across the spectrum of philosophies; one that is comprehensive and doesn’t nibble at the edges of reform as we are trying to do today. It’s bold, hard work, but I believe we should try, and this work starts with honest, candid dialogue about the key fundamentals I mentioned earlier.

Our current state suggests none too subtly that we are not on the same page when it comes to health care policy. I may be an eternal optimist, but I believe that pragmatically we have enough common ground to move ahead, knowing no solution will be perfect or last forever.

Outlined in the white paper are three key strategies to real reform:

Coverage and access to health care Affordability Overall value These strategies must work in concert. If you try to pull them apart, you can end up with solutions that tend to be too piecemeal or tactical.

I also believe that it’s time to innovate and test concepts and practices that may lead to larger solutions.

A state such as Wisconsin, with our heritage of innovation on the public policy front, can serve as an ideal laboratory for what might work on a larger scale. This will require working with federal and state governments and assembling diverse voices and coalitions to agree on fundamental ideas and practices.

In the meantime, any action the federal government takes should work to stabilize the insurance marketplaces so access to coverage is not jeopardized, especially for people who can least afford it. This includes reauthorizing costsharing reduction subsidies for the nearly 130,000 Wisconsin marketplace enrollees who rely on them to purchase affordable coverage and putting all states on equal footing when it comes to Medicaid funding.