Question: What must healthcare reform accomplish?
David Cutler: I think of what reform has to accomplish is three things. One is it has to cover everybody. Both for moral reasons as well as economic reasons, it’s untenable to be in a society where any change in your circumstance, like, for example, a recession, can mean you’re out of the health care system.
Second, is it has to modernize the health care systems so that we really get money for what we put into it—we really get value for what we put into it. The misconception that you referenced is that the idea, the goal, is to save money. The goal is not to save money, the goal is to do things where they’re appropriate, and not do them where they’re not appropriate. Which is a way of looking at it that’s much more consistent with where people are and the values that we have.
And then the third thing that we need in reform is, we need a public health system that actually works to keep us healthy—to keep us safe—that reinforces our medical care system from things like H1N1 Flu, to Avian Flu, to food and water safety, to obesity and smoking cessation.
Question: What do people need to understand about the healthcare debate?
What people need to understand about health care reform is that we can improve the quality of care and lower spending at the same time. Think about those patients with chronic disease who are not getting treated appropriately. Treat them more appropriately, they don’t go to the hospital, they spend less and their quality of life—their length of life is increased. That’s what we can do if we really do it right. So, yes we need to save money, but we will save money as a by-product of having a system that works better.
We are not going to save money by taking a meat axe and just clawing off some part of health care spending. That’s what a lot of the alternative is, if we don’t do this, what’s going to happen? Probably, a lot of the employers will just say “Hey, you know what, we’re just going to stick you in health plan with very high cost sharing—you go out and deal with it.” Everything we know is that people will stop taking their medications to save money and their health will deteriorate.
We have to find a way, and we believe there are ways, where we can save money and we can improve health. And people know this, people know that the healthcare system costs more than it should and a part of that is because the thing doesn’t work right job and you wind up having people in very expensive circumstances after-the-fact, when you could have prevented it.
So, I don’t think that convincing people of that presumption is that hard. I think what we have to do is: one, make sure we do that, make sure that we put the steps in place to do that; and second, is we need to make sure we don’t demagogue it, so we just say to people ‘Oh, what the President wants is to ration your care; or what Senator Kennedy wants is to make sure you don’t get some.’ We need to get away from that, because… its complicated enough, no one’s going to understand all of the details, and if people hear those things and they get scared then they will be tempted to back off—and that would be the worst of all situations.
Recorded on: July 06, 2009
Discuss
Larry Burgess on August 22, 2009, 11:40 PM
David I liked your first post as you bring up that we need to examine what brings our ills – that our water, food, and outlook on health must change. I believe that some radical new thinking about what is healthy in America must be examined. Bromates, chlorine, floride, and even our outlook on salt and why it is or isn’t safe to consume needs to be re-examined. My of the things we take for granted as being safe are not and are causing poor health of Americans.
We also really do need to examine what things cost. You suggest that the value of what we receive be emphasized, but I would in turn ask you to tell me how much should a procedure, a service, or a medicine cost. American consumers are exploited I believe. We do not receive good value, but simply are charged as much as possible.
tim hall on August 23, 2009, 1:56 PM
Larry B. “we do not recieve good value, but are charged as much as possible.” So what would eventually come about if we switched to a form of national health-care? Our national defence dept. is just as you describe and has costly internal auditors as well as external auditors. Has our government lost it’s ability to govern to the masses wishes? Or did it really ever? Does it only govern when we raise enough hell?
Our president is claiming that he can raise tax on folks above $250,000 per year and create more competition through government programs. In the past, we have seen this outcome to be, “new work arounds for claiming income” and “corporations lowering standards and using assets to pay corporate attorneys to fight claims.”
Hillery tried to push a full national health care plan through while having the 1st two years of Democrats in Congress. She failed. Our current president is busting his arse to get any reform with a Democrat Congress. Some sort of go between always seems to leave to many doors and windows open for the leaches. I think the public will end up having to step up to the plate on this one. I will lay down in the street in groups, before I allow the thugs to take my home that I have worked a lifetime to pay for.
When the dust settles, we need to raise hell! not set back and wait to see if we are still getting screwed. Let’s give it time to work, is code for “Let’s see if the public sets on it’s ass a while longer and allows us to pic their pocket.”
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