Health care reform

The Baltimore Sun

In 1993, Hillary Clinton, then the first lady, led an effort to reform the America's health care system that failed, in part because the public was excluded from secret planning sessions. Now, former Sen. Tom Daschle, who is shaping health policy proposals for President-elect Barack Obama, is hoping to do better. He is urging Americans to join in house parties this month to help develop ideas for new national policies to reduce health costs, boost the quality of care and get everyone coverage.

So far, thousands of meetings have been scheduled, and in Maryland, many groups will be gathering in coming days to share their views. In Columbia on Monday, Howard County officials will host a reform discussion. Elsewhere in the state, concerned citizens, physicians and others are planning sessions in their homes.

The current economic crisis reinforces the need for new health policies. We spend over $7,000 per capita on health care, more than twice what other industrialized nations spend, but the quality of health care here clearly lags. Some 82 percent of Americans agree that our health system should be fundamentally changed or completely rebuilt.

While a lively debate is expected in coming months over the mechanisms of reform, the most important goals seem clear:

Health coverage for all: Everyone, regardless of age or employment status, should be provided with an affordable insurance option, including a comprehensive package of benefits. Thus more people would receive primary care to prevent illness and the care of millions with chronic illnesses would improve.

Reorganization of the delivery of care: Medical professionals should be rewarded for banding together into more efficient care organizations where patient information is available to all providers as well as to patients through electronic health record systems. Patients would have better care, more efficiently provided.

Reform of the payment system: Our open-ended fee-for-service system should be overhauled to reduce wasteful and ineffective care and spur innovations to save lives and increase the value of our health care dollars. The new system should reward high-quality care and careful management of resources and correct an imbalance in payment where providers of specialty care are rewarded more than those who offer primary care.

Government leadership: The federal government is the nation's largest purchaser of health care services and thus has tremendous leverage to effect changes in coverage, care delivery and payment. Teamwork with private health care leaders can help develop national aims for health system performance, set priorities for improvement and create a system for monitoring performance.

It's time for Americans to come together and fix our broken health care system.

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