Today, I will give a luncheon keynote at the annual Council on Employee Benefits gathering at the Four Season’s Hotel in Westlake Village in the suburbs of Los Angeles. Last evening, I joined the group for what turned out to be a very memorable evening at the Ronald Regan Presidential Library and Museum in Simi Valley. It was an absolutely beautiful evening and a very special treat to literally dine beneath the wings of Air Force One. If you ever find yourself in the area, I would highly recommend a visit to the Presidential Library.
Being at the library and museum after hours afforded an opportunity to really examine the memorabilia, life, and times of President Reagan. Regardless of political persuasions, I think most of us would agree that Ronald Reagan was not only a charming man, but someone who lead an extraordinary life. It got me thinking about the situation in which we presently find ourselves. What will it take to extract America from this terrible economy? How much of it is due to sins of the past come home to roost versus fear and doubt about the future and our ability as a nation compete globally? And what about healthcare? What kind of system do we really want? Do we want a system that provides a safety net of care for everyone? Or do we simply limp along and make some minor adjustments? Remember, that one in eight American jobs depends on healthcare. In every town across America, healthcare is one of the top employers. We will be tinkering with a system that is a significant force in the American economy.
Other developed nations manage to provide a safety net for citizens and do so for far less per capita than we presently spend in America. We can have universal care and we can have more affordable care, but it is also important to level set on what that really means. It does not mean that everyone gets everything they want any time they want it or need it. It wouldn’t mean that everyone has access to the most expensive and heroic treatments. It is not likely that million dollar cancer regimens, organ replacements, and bionic limbs could be provided to all. Certainly we would need to adjust our expectations about care at the end of life. The emphasis of our healthcare system would need to shift away from sick care and focus more on prevention. There would likely be some kind of rationing of the most expensive and experimental treatments based on co-morbid disease, life expectancy, and other factors. We couldn’t just demand treatment no matter what the cost and expect government to pay for it.
Here at the CEB event, where the setting is truly inspiring, there is a lot of focus on what will happen to healthcare in America. Will health insurance through employers continue to be the model? You may be surprised to learn that even in many European nations that have socialized healthcare, private insurance is frequently in the mix and often provided through employers. Private insurance exists because people want more than the government can or will provide for them.
I don’t claim to have an answer about what kind of health system is best for America. There are advantages and drawbacks to every system around the world. It is clear that we need some kind of change. The question is will we be better off, happier, and healthier as individuals and as a nation when that happens? Time will tell.
Bill Crounse, MD Senior Director, Worldwide Health Microsoft Corporation