Healthcare Hero Ron Wyden

We may have healthcare reform, and we may have it coming out of the Senate Finance Committee, the place where universal healthcare has previously gone to die. In an interview at the “Real Clear Politics” website, Senator Ron Wyden (D-Ore.), a leader of the bipartisan health reform initiative, spells out what the package may look like. Noting that health care costs -- which accounted for less than 8% of America's economy in 1990 and less than 12% in 2000 -- now account for more 17% of GDP, Wyden says, “fixing health care and fixing the economy are two sides of the same coin. . . the reason the take home pay of the American worker never goes up is because health care is gobbling up everything in sight.”

Wyden makes these points:

➢ containing health costs is absolutely pivotal. Make sure individuals are able to pool their funds, so they can be part of a larger group with bargaining power.

➢ stop the insurance market from discriminating against people who are sick. Have insurers compete on the basis of price, benefit, and quality rather than cherry picking.

➢ give people a choice. Even if they have employer coverage, most don't have a choice of plans. Give them the ability to benefit from careful selection of their coverage

➢ More than $700 billion is wasted on administrative paperwork and health care services that do not help people feel better or prevent future illness.

➢ fee-for-service reimbursement rewards doctors and hospitals for volume -- not keeping patients healthy or being efficient. Patient decision aides can guide people through their treatment options for surgery, chemotherapy, and hospice. Pay for performance will send costs down, rewarding areas that deliver quality.

➢ Bundling services, paying a flat rate for a set of services, helps squeeze waste out of the system.

➢ We need tough insurance reforms, and tough malpractice reforms. Democrats are usually for the insurance reforms and Republicans for malpractice reforms. Both are going to have to accept changes.

Wyden believes Democrats have been right on the idea of covering everybody, because if you don't cover everybody then the people who are uninsured will shift their bills to the insured. And Republicans understand you shouldn't turn everything over to the government; that there should be a wide berth for the private sector, for private marketplace choices. But now, Wyden thinks Republicans are saying we have to get everybody covered for economic reasons—that's how you hold down costs; that's how you stop cost shifting. And Democrats are saying look we know what happens if you freeze innovation, if you have a one size fits all governmental standard.

So it looks like a bipartisan bill might work. As he says, “Reformers are very much. . . in agreement . . . [First,] you have to cover everybody. Second, you ought to be able to keep the coverage you have. Third, you've got to reform the private insurance markets, because it's broken. Fourth, you've got to reward prevention. Fifth, would be the value of Health Information technology, which we pursued in the stimulus.”

Finally, Wyden supports a straightforward discussion about how to die without incurring huge costs. He believes we should provide as many choices as possible to American families; no federal government dictating to families what ought to be done or setting up intrusive federal bureaucracy as the arbiter of end-of-life judgments.