ARE STORMS BREWING OVER WASHINGTON?

I recently returned from a Healthcare Reform Meeting in Washington – taking with me a plethora of thoughts and considerations. As part of the Aligning Forces For Quality initiative we discussed changing the way treatment is paid for, how insurance can be designed to cover all individuals equally, and what can be done to make treatment information (with outcomes) readily available to consumers. (It is interesting how change can create jobs, advance careers and provide a vacuum in which so many people choose to live.)

I talked to an individual charged with researching “how things are” so that papers can be created saying “how things should be” in an attempt to educate legislators about how to vote – yet the individual vehemently denied having any role in the policy-making process (her organization has increased from 6 employees to 136 in the past two years).

I heard a “reformed doctor” who has “seen the light” after being treated for a serious illness. Much like an individual who has quit smoking, the doctor has seen the “error in his previous ways” and is now advocating that patients serve a critical role in their own treatment.

It seems like most conventional wisdom is leaning towards changing the way medical care is paid for (by bundling payment under a single bill that encompasses all treatment, follow-up and potential complications). A heavy emphasis is being placed on “common” medical record systems that communicate to each other (though everyone currently having electronic systems wants their current system to communicate in a secure way with everyone else’s system) so that a patient can receive “portable” care. Further, more collaboration is being sought – eliminating some of the competitive mindset that healthcare providers now possess by focusing on regional solutions.

Most at the conference have concluded that a “single payer system” is inevitable – but there was very little common ground as to who would administer such a system, what it would cover and whether or not it would be a “base program” to which people could add should they have the means OR an all-encompassing system that would not create “levels” of healthcare. There were many questions with very few answers – but progress is being made towards discussing some of the best practices that are beginning to emerge.

I met with and experienced good people trying their best to wrestle with a problem out of control – but my return to “West Michigan reality” allowed me to reflect upon some thoughts about government, freedom and how things do (and often do not) get done. While I recognize and acknowledge that I am able to seek and publish quotes that define some of the feelings I experienced in Washington ONLY because our country allows us the freedom to express our thoughts and opinions more freely than any other, my visit was measured with a mix of both cynicism and optimism.

I found several quotes that serve to define feelings about Washington that linger from my most recent visit...please pause to consider them!

• You do not examine legislation in the light of the benefits it will convey if properly administered, but in the light of the wrongs it would do and the harms it would cause if improperly administered. (Lyndon B. Johnson)

• The history of liberty is a history of the limitation of government power, not the increase of it. (Woodrow Wilson)

• Nothing is more dangerous than an idea when it's the only one you have. (Emile Chartier)

• When I was a boy, I was told that anybody could become President. Now I'm beginning to believe it. (Clarence Darrow)

• Politicians are the same all over. They promise to build a bridge even when there is no river. (Nikita Krushchev)

• A government big enough to give you everything you want is a government big enough to take from you everything you have. (Gerald Ford)

• A Committee - The unwilling, selected from the unfit, to do the unnecessary. (Margaret Thatcher)

AND, a last but hopefully not least consideration…

• Due to recent cutbacks, the light at the end of the tunnel has been turned off until further notice.