Michael Rodgers, Interim President and CEO, Catholic Health Association
Americans know their health care system needs repair. Costs are out of control, and public safety net programs are once again under a budgetary microscope. People who are poor and disabled feel the tension most acutely but even those with insurance—many of whom fear high costs or losing coverage—recognize the system is in crisis and insist on change.
With an ongoing war in Iraq and the constant threat of terrorism, compounded by a host of pressing international issues, the sources of distraction are close and constant. Nevertheless the ultimate goal of health care for all must at all times remain visible. Ensuring access to quality, affordable health care services is not merely a matter of system reform. It is a matter of human dignity and of national wellness. We must remind ourselves of that at every turn of the debate.
While health care reform will no doubt continue to place prominently on the minds of a majority of Americans, a broad-based solution to a slate of problems is not in sight, nor is it a top item on the national domestic policy agenda. The public says that it is concerned that the system may be broken, and yet there is no outcry, no concerted message. We lack a national course of action.
A viable solution will not materialize over the next few months, and probably not over the next few years, but the conversation and the mobilization must proceed with new energy and purpose. An honest assessment of the current situation, along with visions of an ideal system, must be summoned from the community and aired in the public square.
How do we reach agreement on what needs to be done? None of us knows, or should pretend to.
So where should we begin? We should at least collectively acknowledge that the necessary national dialogue must take on new urgency and solicit the views of everyone affected by the health system. We are a nation founded on equality and a people who have long understood our special duty to the poor, and yet we continue to tolerate the intolerable.
Academics, policymakers, and others have aptly pointed out that affordable health care is not just a medical necessity but foundational to economic, social, and societal progress. It is difficult to be a productive worker when you are too sick to show up. It is difficult to stay competitive in the global marketplace with a less than healthy workforce. And it is more difficult still to explain why we have yet to substantively recognize and address this set of facts.
I would hope that the national discussion could result in an agreement that quality, affordable health care is a fundamental building block for a free society. As we advance the conversation on health system transformation, we also must continue work on sequential steps that improve access and coverage, such as expanding eligibility under the State Children's Health Insurance Program and providing tax credits or premium subsidies to help individuals and employers afford insurance. These steps and others like them can build upon one another while also advancing the cause of broad-based reform.
The American people deserve more from their health system. Catholic social teaching, and in fact the American constitutional tradition, compel and inspire us to give voice to the voiceless. For 45 million people who worry each time they have to pay for a doctor visit, or become much sicker than necessary because they cannot afford treatment, partisan bickering and endless policy disputes do not mean anything except that the problem continues unfettered. The uninsured need a voice that does not allow itself to be drowned out, no matter what other important issues of the day capture the headlines.
Health care has always posed policy conundrums, but recently greater division and political considerations have overtaken wise policy recommendations. Solutions are usually characterized as having obvious winners and losers, rather than as potential remedies that can improve the lives of people and the health of families. Stakeholders find it easier to choose the status quo than to select an option where not everyone comes out ahead. In the meantime, the number of uninsured continues to grow.
It is time to seek common ground. We can and must put aside partisan political differences to build consensus toward viable, common-sense solutions. We need to allay the fears that reform will strip benefits from those who currently enjoy them, and to set aside the suspicion that any plan will diminish quality while increasing costs.
A number of health care issues will be debated this year. Medicaid, liability reform, Medicare prescription drugs, and quality initiatives are only a few. As we discuss these issues in the halls of Congress and the pages of our newspapers, let us also discuss them in public schools and hospitals, in churches, synagogues, mosques, and other community forums where ideas and information can be productively exchanged.
Most important, those working to amplify the voice of the uninsured and the marginalized are well served to remember that the cause for which they fight is nothing short of a moral imperative.
We are a fortunate nation with plentiful resources and a community spirit rooted in equality and fairness. Now it is our monumental but unavoidable task to express the need for change, to mobilize the nation behind it, and to once and for all meet our obligation not just to the sick specifically, but to one another generally.
Michael Rodgers is interim president and CEO of the Catholic Health Association.
The views presented in this commentary are those of the author and should not be attributed to The Commonwealth Fund or its directors, officers, or staff.