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ADVANCE Perspective: Nurses

Health Reform: All Aboard

Published March 5, 2009 6:35 PM by Rich Krisher
The healthcare reform express appears to be leaving the station. Are we ready?

President Obama convened the White House Forum on Health Reform March 5, bringing together about 150 participants representing government, industry, unions, education, professional associations, community organizations and advocacy groups. It is the first step toward Obama's ambitious goal of restructuring the U.S. healthcare system this year.

I followed the day's proceedings at the White House Web site, which featured a live blog and video feeds.

I hope more careful and deliberate consideration goes into this effort than has been displayed by our political leaders since last fall, with hundreds of billions in bailout dollars shoveled with frenzied urgency into a blast furnace of failed business models. We've seen how that worked out.

The recent corporate rescue schemes and gargantuan government spending plans were crafted by insiders, away from public view. The healthcare effort is getting off to a promising start, with stakeholders on many sides of the matter invited to participate and a more transparent approach being deployed. That is a change for the better from President Clinton's failed reform project of 1993-94.

Still, remarks like this one by the president, as reported by the New York Times, give me pause:

"If we want to cover all Americans, we cannot make the mistake of trying to fix what isn't broken," Obama said. "So if you have insurance you like, you'll be able to keep that insurance. If you have a doctor you like, you can keep that doctor. You'll just pay less for the care that you receive."

That seems a bit much. Everything I like about my current healthcare will be preserved, except it will cost me less? Really? Really.

Maybe that's just happy talk to get the public comfortable with the big transformation to come. But we're not going to cover 40+ million uninsured people and lower prices by finding elusive efficiencies, or punishing hospitals, drug companies, insurers and employers. I'll say what they won't: Reining in this runaway train will require sacrifices by all of us in terms of choice, access and taxes. We also need to take responsibility for lifestyle choices that can lead to negative health outcomes.

The current system is headed for its Wall Street moment if drastic changes are not implemented. What remedies would you put on the table?


I would leave room for free market dynamics to determine supply and demand issues as much as possible.  

Obama's words: "If you have a doctor you like, you can keep that doctor. You'll just pay less for the care that you receive" signal he is planning on implementing government price controls.  See

for a good summary on the problems with government price controls.  

I lived through price control induced gas rationing in the 70's.  I don't want to experience a similar extreme with healthcare.  Healthcare is going to be rationed one way or another, but let's allow market forces to determine how.  Ups and downs in markets will occur but corrections can be stifled by things like govt. price controls.

Years ago I had a job that did not pay much and did not offer me healthcare benefits.  I purchased basic, catastrophic coverage on my own.  That was self rationing.

One thing we could do to reign in healthcare costs is enforce our borders and use disincentives to keep and get illegal immigrants out of the U.S.  Recent studies show that, overall, they are consuming more in resources (such as healthcare) than they are contributing to society.

I doubt my advice will be heeded so I predict we are in for more pain than we otherwise would be.

Mark, R.N. March 7, 2009 3:44 AM

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