Af­ter ar­du­ous jour­ney on health­care re­form, it’s time to take the road less trav­eled

Modern Healthcare - - COMMENT - By An­thony R. Ter­signi

The par­ti­san road to health­care re­form ap­pears to have reached an in­con­clu­sive end, at least for now. But in its wake is an op­por­tu­nity for Re­pub­li­cans and Democrats to come to­gether and im­prove our health­care sys­tem in a bi­par­ti­san way.

Hope­fully, one of the lessons learned from the past few months and years is that par­ti­san­ship does not work when it comes to the na­tion’s health­care. Par­ti­san ef­forts take things in an ide­o­log­i­cal di­rec­tion that is not sus­tain­able, con­sis­tent or sta­ble over the long term.

Both par­ties now need to reach across the aisle and de­velop a bi­par­ti­san piece of leg­is­la­tion to fix the very real prob­lems that plague our health sys­tem and those who rely on it for their care.

Our na­tion’s lead­ers have tack­led some of the most sig­nif­i­cant chal­lenges in our his­tory through bi­par­ti­san co­op­er­a­tion, in­clud­ing civil rights leg­is­la­tion and So­cial Se­cu­rity re­form.

In the wake of re­cent leg­isla­tive ac­tiv­ity, what our na­tion needs now is a two-step process. First, to main­tain and shore up the in­di­vid­ual mar­ket, the ad­min­is­tra­tion should con­tinue fund­ing cost-shar­ing re­duc­tion sub­si­dies while Congress pre­pares leg­is­la­tion as quickly as pos­si­ble to pro­vide this fund­ing on a more long-term ba­sis. Sec­ond, Congress should ini­ti­ate hear­ings on im­por­tant longer-term is­sues to strengthen our health­care sys­tem.

Th­ese hear­ings could ad­dress real, sys­temic is­sues that in­clude im­prov­ing an in­di­vid­ual in­sur­ance mar­ket that in many states is not func­tion­ing well as ev­i­denced by the ex­o­dus of in­sur­ers; in­creas­ing the ef­fi­ciency of our health sys­tem; sup­port­ing manda­tory en­ti­tle­ment pro­grams for the el­derly and the vul­ner­a­ble; ad­dress­ing the sky­rock­et­ing costs of drugs and de­vices; and de­mand­ing more ef­fi­ciency out of providers and health sys­tems.

Be­cause this kind of long-term health­care re­form is needed, I ask both par­ties to do what seems dif­fi­cult now, but what was achiev­able back in the 1960s with the cre­ation of Medi­care and Med­i­caid, and in the 1980s with So­cial Se­cu­rity re­form—put aside po­lit­i­cal dif­fer­ences and work to­gether.

Sen. Chuck Schumer (D-N.Y.) put it well af­ter Re­pub­li­cans failed to en­act any ver­sion of re­peal: “We are not cel­e­brat­ing. We are re­lieved. ... So let’s turn the page and work to­gether to im­prove our health­care sys­tem.”

Some el­e­ments our coun­try needs

to se­ri­ously con­sider in­clude ex­pand­ing waiver author­ity for states to be more ag­gres­sive in cre­at­ing ef­fi­cien­cies in Med­i­caid and in their in­di­vid­ual in­sur­ance mar­kets; al­low­ing for more ro­bust and cre­ative uses for health sav­ings ac­counts; and agree­ing to al­ter­na­tives to the in­di­vid­ual and em­ployer man­dates. We also can­not harm the very peo­ple who need care the most by sig­nif­i­cantly cut­ting Med­i­caid. This ef­fort will likely need to rec­og­nize that the fed­eral gov­ern­ment has an im­por­tant role in the in­di­vid­ual mar­ket as the rein­surer of last re­sort for a small num­ber of very high­cost pa­tients so in­sur­ers will have the con­fi­dence needed to re­main in the in­di­vid­ual in­sur­ance mar­ket.

We are at a clear cross­roads for health­care re­form. The par­ti­san ap­proach has been right­fully crit­i­cized from all cor­ners, in­clud­ing most im­por­tantly, pa­tients. The temp­ta­tion is for each side to re­treat to their re­spec­tive cor­ners and blame the other party for the fail­ures that are on the im­me­di­ate hori­zon. That is not the lead­er­ship we need at this point in the his­tory of our on­go­ing dis­cus­sion on health­care.

This jour­ney must start with the im­por­tant step of re­al­iz­ing that bi­par­ti­san­ship and courage are the only way to ad­dress the very dif­fi­cult is­sues fac­ing us. In the words of Sen. John McCain (R-Ariz.), a man who knows some­thing about courage: “The Congress must now re­turn to reg­u­lar or­der, hold hear­ings, re­ceive in­put from mem­bers of both par­ties and heed the rec­om­men­da­tions of our na­tion’s gov­er­nors so that we can pro­duce a bill that fi­nally pro­vides Amer­i­cans with ac­cess to qual­ity and af­ford­able health­care.”

The Bi­par­ti­san Pol­icy Cen­ter has put to­gether a Group of Ten from all points of the po­lit­i­cal spec­trum to pro­vide needed, bi­par­ti­san thought lead­er­ship. Congress would do well to call on this stel­lar group to jump-start re­form.

Now is the time for lead­er­ship by brave mem­bers of Congress and the ad­min­is­tra­tion who are will­ing to start the jour­ney and walk to­gether along the road less trav­eled to solve very real prob­lems on be­half of the Amer­i­can peo­ple.

An­thony R. Ter­signi is pres­i­dent and CEO of St. Louis­based As­cen­sion.

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