The Health care debate and discussion continues to be distorted, disconnected and downright disingenuous. It is impossible to have any serious national, regional or local discourse and debate about the reform of health care in our society. The so-called stakeholders table convened by the Obama Administration has conspicuous absences, including those who advocate for a single payer delivery system. COTT has always seen some “American Hybrid” of a single-payer system as the most sound policy and economic choice for the United States to deliver quality, affordable health care to all it’s citizens. To even consider this option we must cut through the misconceptions and outright falsehoods currently being circulated.

We must take a hard and critical look at the impact “Shareholder Value” has on health care decisions. Short-term economic value is not the right gauge for the health and sustainability of our health care system; In fact, short-term shareholder value undermines attempts to steer the system toward positive health outcomes and as a result long-term savings to the American taxpayer. Positive health outcomes include, strong preventive medicine components that lessen morbidity and mortality in our citizens thereby saving precious health care dollars over the long haul. In essence, while not abolishing private health care, we must place shareholder value in its proper perspective if we are to implement sound, quality, and affordable long-term health care for all Americans.

The system must be primarily driven through the measurement of health outcomes across all sectors of our society. Good disease management and care planning ensure positive outcomes in chronic disease communities thereby reducing the overall cost to the taxpayer. A healthy dose of ongoing health and disease education for those with chronic disease greatly enhances client/patient adherence to their treatment program or plan. These are the ways we seriously plan good policy to ensure long-term access to quality care for all Americans. The current discussion is far from this place and it is all our responsibility to get involved and demand a serious national discussion regarding health and wellness for the American people. We must move beyond this claptrap and disingenuous righteousness, and get to the good policy, good science and good national sense that will lead us through this critical national issue. Remember health is a right and not a privilege.

We hear these outrageous statements coming from “alleged” community residents at Town meetings who lament the loss of “America” and warn us against the totalitarian nature of Obama and health care reform. It is to absurd to even be considered; yet it gets reported and discussed in the media. We continue to hear, the now parroted statement, that we have the best “medical system” in the world. Yet by United Nations standards the US is 39th in the world in national health outcomes. Our infant mortality rate is far too high, and for the majority of Americans high end medical care is only for those wealthy enough to afford high quality, high premium insurance. The US remains one of the only western democracies where thousands of its citizens are bankrupted each year due to their overwhelming medial bills.

It is so distressing when I hear ordinary people complain about the high percentage of national cost that is represented by chronic, high cost disease. Yes, we do represent about 76 percent of the health care expense. However, where is the sense that we as Americans are in this together and must work together to justly and equitably solve the health care equation? Why do we not view health care as an important national issue that we must solve together through robust and informed discussion and discourse. We remain mired in rhetoric, falsehoods and obfuscations of the truth. How do we propose to come to any good policy decisions when the discussion remains clouded in a haze of misdirection?

In the current climate we are destined to only partially address the current problems in health care. In reality, universal access, standing alone fails to address serious parts of the health care problem, such as the attainment of positive health outcomes for all Americans, both healthy and those facing chronic disease.

As a person with hemophilia, a bleeding disorder, I am keenly aware that adherence to my care plan and good health practices individually ensure less long-term problems associated with my hemophilia and therefore less cost to the system to care for me. In the language of health it means that if I attain good health outcomes my care will be less to the system. The clotting factor I use to treat my recurrent bleeding episodes cost roughly 400 thousand dollars per year depending on how much I bleed. For all of use education regarding healthy practices must be a more robust and vibrant component of our health care if we are to all do the things that produce positive health outcomes and significant savings to the health care system. If we apply this concept system-wide, we can then raise the overall health and wellness of our citizens, reduce long-term cost and greatly enhance the sustainability of our health care system.

by Corey S. Dubin, President, Committee of Ten Thousand