Time To Weigh In On Health Reform

September 23rd 2009

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Posted by Gil Friedell, M.D.
Friedell Committee for Health Transformation
 
Citizens of Kentucky — and of the United States — have a lot riding on the current national debate about health care reform, and our representatives and senators need to hear from us.
 
The health of individual Kentuckians and of our communities will depend on the action taken by them in the few next weeks and months.
 
Kentuckians have agreed, according to surveys, that we are dissatisfied with our current fragmented and dysfunctional health system. Moreover, it's a system that excludes a significant number of us.
 
We have further agreed that we want a well-functioning system that would provide each of us with affordable, coordinated, comprehensive, high quality health care which includes preventive services and which continues uninterrupted as we move from one job to the next or from one phase of life to the next.
In addition, during the past several years Kentucky citizens have said they want this system to be based on a clearly stated set of values. These values were first enunciated in 1992 at a time when health care reform was being considered both in Frankfort and Washington.
 
Five thousand Kentuckians participated in forums in each of our 15 area development districts to "voice their opinions, concerns and personal experience" about health care. Their comments were recorded and collected in some 2,000 pages of transcript.
 
Two years later, an independent investigator for the Kentucky Center for Public Issues went back to the transcripts and identified and reported the values expressed at the meetings.
 
Since then, similar values have been put forward by other Kentucky individuals and groups, and comparable values have been expressed at the national level, including in 2005 when the congressionally mandated Citizens' Health Care Working Group collected the views and values of thousands of people in community meetings and via the Internet.
 
In 2005, a statewide, independent, non-partisan, Kentucky citizens' committee (subsequently named the Friedell Committee for Health System Transformation) was formed to draft a set of values-based principles, including those advanced by the forum attendees in 1992, to form the basis for a high-performance health system in Kentucky.
 
The committee concluded that this system should reflect these 10 values:
n  Health systems are accountable to the public
n  Health systems are responsible for promoting the health of individuals and populations.
n  Health professionals are responsible for providing safe and effective care.
n  Each individual has fair and equal access to care.
n  Care for each individual is of high quality.
n  Care for each individual is affordable.
n  Care is efficient and of high value for recipients and families.
n  Patients and families are treated with respect.
n  Patient rights are clearly expressed and honored.
n  Individuals and communities share responsibility for health and the cost of care.
These principles reflect not only the concerns of the public, but of a broad array of health professionals and organizations.
 

They can, and should, be used now as benchmarks to evaluate the present troubled system and included as foundational elements in any revised system, including any reforms proposed by Congress.

And we believe the principles will stand the test of time when used as oversight criteria to evaluate whether a new system is working or to test subsequent proposals.

It is obvious that the services we need and deserve must be paid for, and in the end the cost of a transformed system — something we have agreed we need — will be borne by us, the citizens of this state and country.

We therefore have the right to weigh in not only about the cost of the health care package, but about its contents as well, and about how the system should provide care for all of us

Our nation "found" trillions of dollars in the past eight years to fund two wars and then "found" trillions more to deal with acknowledged mistakes in our financial systems.

Our steadily worsening national health status and health care services crisis demands that we "find" the money to meet this challenge as well.

This isn’t about whether we should have government health insurance, private insurance or some combination of them. Rather, it's about making sure that a badly needed, reformed system, however it is financed, rests on values-based principles.

And now is the time for us to send this message to our elected officials.

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