Today's Seattle Times Columnist, Jerry Large (Inequality may sicken us — really) very rightly says that the candidates have health care plans, but no health plan. 

We don't need to wait until Wednesday at 11 pm to watch "Unnatural Causes."  You can watch clips online.  Here is a link: Unnatural Causes.

I would add to Jerry Large's comments, that even though the candidates have health care plans, as they are currently constituted, they would not pass because they would not get the support of Independents or the moderates of the other party. 

That's why we need to build a bipartisan Voters' Health Care Platform so we can hold them accountable to us for what we need and want.

Cheers and more later.  Kathleen

Last night, PBS aired the first part of a four part series on health care called Unnatural Causes.  Here is a link to the first show. 

http://www.pbs.org/unnaturalcauses/

This documentary will run every Thursday for four weeks:  March 27th, April 3rd, April 4th and April 17th.  I urge you all to view this documentary.  

We have a new function now with our new website – a Discussion Forum.  On Monday as we test this function, I invite you to an online discussion of this documentary and explore its implications for health care reform in America.  

Cheers and more later.  Kathleen

Health Populi had a great blog yesterday on the new HarrisInteractive and Harvard School of Public Health's latest poll on American's knowledge of other health systems. 

Clearly we are myopic as a nation about other health care systems.  For those who have George Halvorson's book, Health Care Reform Now!, he has a nice chapter on what other countries do.  I am teaching a class starting in late April about what other countries do for health care and how they got to reform.  Starting in late April, we will focus on health care in other countries and see what we can find. 

One thing for sure: There is no cookie cutter approach to health care reform. 

Cheers and more later.    Kathleen

Maggie Mahar of Health Beat is doing a three part series on obstacles to reform.  I think one of the biggest obstacles to reform is language. We get stuck in divisions of health care is a right vs. health care is a responsibility rather than focusing on the priorities we have for health care and what a health care system is actually suppose to do. 

What we found in our work in Iowa and Washington is that when you take away some of the language of reform and ask people what they want and what is important to them, it changes the nature of the discussion and allows us to find areas of common ground, which means that we can use this common ground to build consensus rather than fighting over whether health care is a right or not.

Bottom line is that the majority of Americans think we need to cover everyone.  What we don't agree on is how. But, we can have that conversation when we focus on solving a practical vs. ideological problem. 

Cheers and more later.  Kathleen

Once again the findings from our Iowa and Washington surveys are upheld in another poll, this time by the Harvard School of Public Health and Harris Interactive.  In our surveys, it is the Independents who make a critical difference on key elements of health care reform. The Harvard Study, it turns out finds that they are key to how the health care system is perceived. 

I don't know if the candidates read health care polls or not. If they do, they should be worried.  Why? Because none of their plans, as they are presently constituted, will gain the support of the Independents or the moderates of the other party, which both parties will need when it comes to health care reform. 

None of them address payment reform or complementary and alternative medicine.  You cannot get to fundamental reform without addressing provider payment.

Returning to the issue of Independents; they are critical to both parties if any of the party platforms are to succeed.  The trouble is--how do we know what the Independents want?  They don't have conventions and platforms.

The challenge facing both parties will be appealing to that group, which can range from 30 to 40% of the voters.  The other challenge is that the core voters in the Democratic and Republican Parties live with very different world views and literally do not see each other's world views.  Which is why we cannot leave health care to the parties and need to have a "Voters' Health Care Platform."

Cheers and more later.  Kathleen

Yesterday we remarked that the need for reform is urgent with the recession and dwindling state budgets.  Today it was announced that an additional 22,000 people applied for unemployment benefits, bringing the total claims to 378,000 people.  There is no indication how many of these people have health insurance or access to insurance from their spouse or other sources.

Cheers and more later.  Kathleen

Heads up Governors.  Here’s the recession.  This means fewer tax revenues and smaller state budgets.  What this means to Governors and other state budget makers is how to balance their budgets with Medicaid being the fastest growing part of state budgets. 

Last time around, Tennessee cut 190,000 people from Tenncare to balance their budget. Mississippi actually threatened to cut 13,000 nursing home beds to balance their budgets.

We need health care reform NOW!  We need systemic, bone changing, positive reform. Fortunately, there are new fresh voices, in addition to ours, seeking such reform.  We are beginning to have more and more similar messages. 

Cheers and more later.  Kathleen O'Connor

I am hopeful we will have our online Discussion Forum this week.  We are also planning on starting in person discussion groups this month, as well. So, where shall we start our discussion? 

I will be bold enough to suggest that we assure that a majority of Americans believe we need to cover everyone – that we agree on Universal Coverage.  Our data and other polls show that is a save assumption to make.  How we manage and pay for those benefits is the issue. 

One theme has consistently emerged when it comes to health care benefits: focus on prevention and wellness over high tech cures.  I think it would be a productive discussion to focus on prevention and what that would mean for a benefit package for everyone and how we would reward physicians for focusing on health rather than relying on them exclusively to fix our ailments.

Right now, no money changes hands unless a doctor does something to fix us or we have an annual exam. 

So, what would a system look like if we focused on health promotion and disease prevention?  What benefits would be covered and how would we compensate physicians? 

Cheers and more later.  Kathleen O'Connor

P.S. My apologies for the disrupted blog.  My laptop hard drive crashed just as I was leaving town for the Mayo Symposium, which crippled my online access and capability. 

I am now back on target with a new hard drive and ready access to the internet. 

Hats off to the Mayo Clinic and their Health Policy Symposium. This was one of the most refreshing health care policy symposiums that I have been to in the past 30 years. We started CodeBlueNow! nearly five years ago out of my total frustration with the quality of the health care reform debate in this country.

While the Mayo Clinic may have come to some solid conclusions about what their members and colleagues want in health care reform, what was so refreshing to me is that they were not pushing any agenda down people’s throats and were very committed to listening to what the attendees have to say.

I think we are seeing a sea change in the health care reform debate that is different from the debate I have followed over the past 30 years. New visions and new voices are emerging, which for the first time is reaching out to the public.  The public is the only group that has been consistently been left out of reform since the get go–since the first report on health care reform: The Committee on the Cost of Medical Care in 1932.

Consistent themes have continued over time. The challenge is–we have left the health care system to the industry stakeholders, when it is you and I, the American public who are the only voters who can give politicians their jobs. That’s why we need to find common ground and build consensus together, so we can have reform vs. more endless debate.

Congratulations and thanks to the Mayo Clinic for being a fresh voice in a public reform debate.

Kathleen O’Connor

Kathleen is traveling this week on business attending the 2008 Mayo National Symposium on Health Care Reform just outside of Washington, DC.  This conference builds upon the works from the two previous symposiums, and is attended by national leaders from all areas affected by health care issues. 

The website for the conference, http://www.mayoclinic.org/healthpolicycenter/2008-symposium.html,  notes it will “convene to create highly participatory, action-based proposals for reform.”

What is exciting about this conference is people are finally starting to talk about patient-centered care.  The four cornerstones for patient’s needs they will be discussing this week are:

     1. Insurance for all
     2. Coordinated care
     3. Producing value
     4. Payment reform

Kathleen will check in over the next day or two to give updates on topics and ideas discussed at the conference.

There may be some surprises ahead in the presidential campaign, but the race is now officially narrowed down to three candidates.  What is abundantly clear from these three candidates is the inadequacies of their health care reform proposals.  Clinton and Obama may argue with each other over who has the better plan, but neither has real cost containment strategies.  NY Times’ Robert Pear delineated the inadequacies of their plans in Monday (March 3rd) New York Times.  Read the article here. 

CodeBlueNow!’s research from Iowa and Washington had identical findings from two very different red and blue states.  The candidates are clearly not addressing some key issues of concern to the American public.  McCain’s proposal is even more vague. 

We cannot leave the health of our nation to political candidates who follow very rigid party lines of access, cost, quality and coverage. The majority of Americans want everyone covered.  They want this because they understand that not covering everyone costs them money in their current premiums. 

We will have a discussion forum on our website by the end of the month.  We must start thinking now how we can create a Voters’ Health Care Platform that we will give to the candidates, so we can identify what is important to us in health care reform. And then demand they address our needs.   

Please see what our survey shows the public wants and where the candidates are at. We, the People, need to lead this discussion.  

We have more in common than we are led to believe by the pundits and the parties. 

We would also like to acknowledge and thank HealthCareReformNow.org for their thoughtful article on our research findings.  We highly recommend Halvorson’s Health Care Reform Now! book to you. 

He has many thoughtful ideas that we need to examine, explore and discuss. 

Cheers and more later.  Kathleen

We have another winning view on health care from Mike Magee, MD and his book Home Centered Health Care: The Populist Transformation of American Health Care.  His chapter, “A Focus on the Home” raises some excellent points on what our health care ”Carousel of Progress” could look like. 

He offers a ten point vision of the new healthy American home:  

1. A Home Health Manager for each extended family member.

2. Health insurance covers nearly everyone, and there is a medical information highway. constructed around the patient, with caregivers integrated into it.

3. The Majority of prevention, behavioral modification, monitoring and treatment of chronic care takes place at home.

4. Physician-led, nurse-directed virtual health networks of home health managers provide 24/7 community-based educational and emotional support.

5. Health care costs go down due to expert performance of the home health manager.

6. Basic diagnostics are performed by the home health manager.

7. Sophisticated behavioral modifications tools, age-adjusted for each generation, are present and utilized.  

8. Physician office capacity grows because most health care does not require an office visit; Physician reimbursements increase in recognition of their roles in managing complex clinical and educational teams and multi-generational complexity.

9. Family nutrition is carefully planned and executed; weight is down and cognition is up.

10. Hospitals continue to right size---they’re more specialized and safe with better outcomes.

Impossible?  Dr. Magee doesn’t think so.  “Many of these elements are well within the reach of an integrated and progressive vision for tomorrow’s health.  What is missing is our willingness to concentrate and focus on homes as the cornerstone of a new preventive health care system” (Magee 40).

This is a great point to start discussing what a new health care system could look like.  We invite you to visit Dr. Magee’s website and blog:  www.healthcommentary.org

Cheers and more later.  Kathleen

With the presidential campaign upon us, group after group is forming to prepare for a health care reform battle.  The trouble is most are forming along traditional ideological lines: Single payer vs. marketplace; labor vs. business; progressive vs. conservative.  They will hurl accusations at each other and try to shout the other out, as these groups have every time health care reform has been on the horizon – since 1932.

Yes, since 1932!  I have a copy of the Report: Committee on the Cost of Medical Care (1932, University of Chicago Press).

We don't need a battle on health care, we need consensus.  Despite what these various groups think, there is more consensus on health care than the parties or the pundits would lead us to believe.  Our findings from Iowa and Washington show there is strong congruence on many issues between these two different states.  The fact that these two states are mirror images of each other shows that the American public has thought about health care for a long time and that they have come to some strong conclusions: we need to cover everyone;  we need a basic benefit package; we should have our choice of health care provider – not just medical doctors, but any licensed health care professional; that we need more information and accountability from the system; and there is enough money in the health care system if we use it more efficiently.

The people want neither government-run health care or totally marketplace and health savings accounts.  What they want – and we have the data to show it – is a shared responsibility of employers, individuals, and the government. 

That middle ground is our strength. That is where we can find common ground and build consensus. Americans are a pragmatic people who like to, and are geniuses at, solving problems. 

We must get health care out of the hands of political parties and the traditional health care reform and advocacy groups. They clearly are not capable of any drum beat but the one they have always drummed.

Recent articles in The Economist and Newsweek talk about a post Boomer and post-racial politics, which are not founded on the confrontations of the civil rights, women's rights and anti-war movements of the 60's, but rather a new politics of collaboration.  We need each other. 

Without collaboration and consensus, it is clear from our data that we cannot get to reform without it.  Independents now play a critical role. Neither party can win without them.  Therefore, old confrontational politics inevitably fail.

Cheers and more later.  Kathleen