On health reform, eye on the prize

Posted June 29, 2009, at 6:03 p.m.

When it comes to health care reform, I think like my dog: In the end, only a few things really matter. For the dog, it’s food, friendship, her favorite worn tennis ball, a place to sleep and whether she reaches the end of the leash before she reaches the neighbors’ cat. For you and me, all that should really matter in the national health care reform debates is whether everyone gets insured and whether universal insurance is affordable.

Keeping it tennis-ball simple is important for a few key reasons. First, health care policy issues are more complex than most of us will ever have time to fully understand, so why waste time focusing on any issue other than whether we all get insured and how we pay for it?

Our ignorance on this stuff is not due to lack of intelligence. Rather, it’s because few of us are ever going to have the time necessary to really know what we need to know to have a truly informed opinion. I am a hospital CEO, a physician and a (world famous!) health care columnist who reads lots about health care, and even I don’t know enough to know what to think about some of these divisive issues in health care reform. Maybe I am projecting, but I doubt you know a lot more. That makes it almost impossible for you and me to really know whether any particular way of reforming health care in America is a good one or just dumber than a dog on a short leash chasing a cat.

Take, for example, the broad issue of how we pay for everyone to be insured. Articles galore are by written by health care policy experts debating this issue, and my bet is, neither of us has read all of that wisdom. Nor can most of us cite or quote any of those experts (Rush Limbaugh and Jon Stewart don’t qualify). Our knowl-edge of the many of the other complex pieces of this puzzle is also probably pretty limited.

Second point: The only issue of real importance to Joe the Patient is whether everyone in America has a workable health insurance plan. Any other issue within the health care reform debate is irrelevant by comparison, whether it’s how we pay for universal insurance (in the end, you and I are going to pay for it one way or the other), or whether we have private or public insurance, or yada yada yada. If you disagree, ask yourself this question: Will any of the other health care reform issues being fought over really matter to you if you lose your current health insurance, then get sick and lose your house when your medical bills bankrupt you?

No, is the answer, and leads to the third point. During previous efforts to reform health care we have gotten distracted by the rhetoric put out by various interest groups and political parties manipulating our fears in order to pursue their own agendas, then lost our will to force our leaders to deliver on the reform. If you and I focus on all of the ancillary issues and the debate around each, chances are we will make that mistake again.

Instead of doing that, this time let’s tell our political leaders we care about nothing except their delivery of universal insurance to the American public this fall. Their job is to sort out the details, our job is to put tremendous political pressure on them until they get it done.

If we don’t hold them to that one, crucial, difficult goal, we may blow the best chance in more than a decade to finally get all of us insured. We will have fought to the point of an exhausted impasse over the details while all that really mattered to most of us was having a health insurance plan that protected us from financial ruin when we got sick, and gave us access to the health care necessary to keep us all well.

Universal insurance is all that really matters. On that, you, me and the dog should all be chasing the same cat.

Erik Steele, D.O., a physician in Bangor, is chief medical officer of Eastern Maine Healthcare Systems and is on the staff of several hospital emergency rooms in the region. He is also the interim CEO at Blue Hill Memorial Hospital.

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