You may be dubious that a big health insurer has much to add to the policy debate. But buried inside many of the giants are some interesting people indeed. Case in point Humana and its attempt to start an open discussion about reform. Here’s Fard Johnmar to give his perspective.
In late 2003, Congress funded a potentially powerful initiative designed to engage ordinary Americans in a dialogue about health reform. This project, The Citizens’ Health Care Working Group (CHCWG), was funded along with the controversial Medicare Part D program. It was designed to ignite a national public debate about how to improve the US health system so that “every American can obtain quality, affordable healthcare coverage.” Beginning in 2005, 14 people, handpicked by the US Comptroller General held a series of meetings with ordinary Americans (the Secretary of Health and Human Services (HHS) served as the 15th member). In addition, thousands of Americans chimed in online with their ideas for changing the system. They made the following recommendations: -Establish Public Policy That All Americans Have Affordable Healthcare-Guarantee Financial Protection Against Very High Healthcare Costs-Foster Innovative Integrated Community Health Networks-Define Core Benefits & Services For All Americans-Promote Efforts To Improve Quality Of Care & Efficiency-Fundamentally Restructure The Way End-of-Life Services Are Financed & ProvidedIn September 2006, the Working Group delivered its recommendations to President George Bush. In March, the president responded by rejecting CHCWG’s proposals. HHS Secretary Mike Leavitt explained the president’s decision, saying that Bush agreed with many of the Working Group’s goals. However, he “supports an approach emphasizing consumer choice and options . . . rather than mandates and government intervention.” Fundamental Healthcare Reform: Forever Stuck On Neutral? Bush’s response to the Working Group’s proposals highlights a key barrier to fundamental healthcare reform. There are serious differences between many groups on how to radically change the system, which creates almost insurmountable logjams. As William Roper, dean of the University of North Carolina School of Medicine, observed in the latest edition of Health Affairs: “The lesson of time, at least in quarter-century increments, is that the United States is fundamentally conservative in its view on changing its healthcare system. Despite talk then and now by health policy elites about ‘fundamental reform,’ most changes in the U.S. healthcare system have been incremental.” I agree with Roper. Unfortunately, fundamental change will remain stuck on neutral for the foreseeable future. Yet, we still have urgent problems that demand answers and the clock is ticking – in more ways than one. In another essay published in this month’s edition of Health Affairs, Leonard Schaeffer suggests the usual suspects are running out of time to shape policy. He thinks, “budget hawks and national security experts will eventually combine forces to cut health spending, ultimately determining health policy for the nation.” We must not allow this nightmare scenario to come to pass. Although CHCWG Hit A Brick Wall, Is People Power Still The Answer? Although CHCWG failed to gain traction, getting the masses involved in reform efforts is a good idea. However, we need to quickly move from attempting to broadly shape health policy to immediately implementing concrete ideas for change. Fortunately, enterprising individuals, corporations and government agencies from across the country are chipping away at the system’s problems. Unfortunately, these ideas often do not catch on nationwide because we don’t know about them. This is where Humana comes in. On November 19, the health company will officially launch Change Now 4 Health (CN4H), a broad, grassroots coalition committed to improving the nation’s healthcare system through immediate action. Although launched in the shadow of CHCWG, Humana is not reinventing the wheel. Rather it is: -Using Web 2.0 tools including blogs and online forums to form communities of change-oriented individuals to address specific problems-Doing its best to encourage rapid action rather than more recommendations for change that may or may not be implemented by policymakers -Using the wisdom of crowds to focus national attention on solutions to our shared problems -Allowing the community to come up with ideas rather than trying to control the conversation Of course, the biggest question is whether Humana can credibly manage this effort. If it were trying to control CN4H from above, the answer would be no. Instead, the company is doing something revolutionary (for the health industry). It is providing the platform for CN4H, but leaving it up the community to determine its own direction. Humana is putting its trust in the collective expertise of the public to determine its own course. How Will CN4H Move Beyond Talk To Action? Ultimately, Humana hopes to generate concrete ideas by facilitating three levels of online dialogue about reform:-Level 1 – High Level Issues: Humana has recruited a number of individuals (I am one of them) to develop blogs on key problems facing the health system. While we are being compensated for our time, Humana is leaving editorial control of the blogs to us. My blog focuses on how we can help consumers make better health decisions. Humana has not edited or censored any of my blog posts. –Level 2 – Concrete Ideas For Change: This month, Humana will launch a series of online forums where individuals can discuss ideas for change. –Level 3 – Idea Submission & Discussion: To encourage public comment, Humana will produce an online form where people can submit their ideas for changing the system – today. These ideas will be funneled into the bulletin boards and discussed on the community blogs. Also, community participants will be able to vote on ideas. Spreading Ideas For Change Humana has committed to help spread the ideas generated by the community in a number of ways. Most importantly, the company will fund the production of an e-book, tentatively titled “50 Ideas For Changing Health Today.” The fifty ideas receiving the most votes by the community will be featured in the book. This free publication will be made available on the CN4H Website and major online book retailers, such as Barnes & Noble.com and Amazon.com. Humana will also distribute the book to stakeholders in both the public and private sectors. CN4H: Putting The Wisdom Of Crowds To Work I decided to become involved with this effort for many reasons. (And, although it is nice to be compensated for some of my time, money had very little to do with it.) Most importantly, I am a firm believer in the power of the wisdom of crowds to solve the most complex and vexing problems – health reform certainly qualifi
es. In addition, I have been frustrated that previous efforts to change the health system have resulted in a lot of sound and fury, but very little action. We need reform now, and our collective wisdom and intellect can make a real difference. I encourage everyone reading this post to: –Visit The CN4H Community Website: Currently, the site features blog posts, but Humana will be deploying additional tools and features at and after the program’s launch –Spread The Word: We are relying on the online community to shape the program. Please help us by spreading the word about CN4H –Discuss, Submit & Vote On Ideas: Help make the e-book “50 Ideas For Changing Health Today” a reality by discussing, submitting and voting on ideas generated by the community I look forward to seeing what we can do together.