Accentuating the Positive

Much has been written and said about the “downside” of the recently passed reform of the health care “system”. It’s the end of capitalism in America, the budget-busting doom of the country, tantamount to child abuse and, yes, it’s the end of life, liberty and the pursuit of happiness as we know it. Literally, it’s the end of life, at least for Nana once the death panels are set up.

But, isn’t there an upside? Would access to an annual routine physical exam as a covered benefit under Medicare, with no co-payment, qualify as a positive outcome? What about closing the “donut” hole? How about eliminating the denial of insurance coverage for pre-existing conditions. Isn’t the focus on primary care and preventive medicine a good thing? Especially with our nation leading obesity stats?

Tom Eblen, writing in the Herald-Leader last week pointed out a new report from Kentucky Voices for Health that highlights the positive impact health care reform will have on Kentuckians. While acknowledging that there are big questions that are unanswered such as what impact the law will have on rising costs, Eblen points out that there are many positives, especially for a poor state like Kentucky.

His piece was followed up in the H-L opinion pages in a letter from Judy Myers, a member of the Board of Directors of the Friedell Committee for Health System Transformation (full disclosure…I am a member of this group). One of Judy’s sentences resonates with me: 

“I am concerned that resistance — coupled with insufficient vision and knowledge of what is possible — may lead us to squander this opportunity.”

She is absolutely right. Rather than predicting the end of times, we need to look for the opportunities that the reform presents to our cash and health-poor state. That’s why I am an advocate for reforming Medicaid through the use of a managed care (or better said, ‘managed health”) approach. And, her point of view reflects a feeling on the part of many that our legislators and members of the administration should be more concerned about the welfare of all Kentuckians than their own political welfare.

In the end, we need to start substituting the connective “and” instead of “or” when we look at our opportunities. The question usually is can we have better health or lower costs? Let’s ask how we can have better health AND lower costs?

That frame of reference may lead us to a much different place.


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