The Center for American Progress (CAP) released a new “Blueprint for Reform” that focuses on how to fix the delivery system. This well-constructed
document and provocative forum was spearheaded by CAP CEO John Podesta (former Clinton White House Chief of Staff) and Jeanne Lambrew.
There are a few things that really show good progress in the
national debate. First, the fact that CAP has chosen this critical time
at the precipice of the national health care reform debate to focus
attention on reforming care as well as coverage will be helpful to
facilitating that discussion in 2009 policy debates (they, of course,
support coverage initiatives as well but those aren’t addressed in this
Second, the quality and thougtfulness of the work and recommendations is high. Not surprising given the exceptional collection of authors with each chapter co-authored by a physician and a policy expert. These
include: Don Berwick, Tom Lee, Judy Hibbard, David Blumenthal, Bob
Berenson, Paul Ginsberg, Steve Schroeder, Dora Hughes, Chiquita
Brooks-LaSure, Karen Davenport, and Katherine Hayes.
Finally, it was encouraging that CAP identified patient
activation/second-generation consumer engagement as one of the six
domains (chapters) that must be addressed in a reformed delivery
system. The authors define second-generation consumerism as “engaging
and activating patients to better manage their health,” which
represents an important step beyond just throwing information at them
and making them financially accountable for their health care
spending–which, as the authors point out, research has shown doesn’t
really accomplish the things we want.
What I would like to see CAP do more of in the future is better
integrate that patient activation component into the infrastructure
section (not surprisingly, much of what the IxCenter works on). To be
specific, many of the opportunities for engaging and activating
patients need to be better embedded into the health care delivery
system infrastructure. That means not just giving consumers access to
personal health data via electronic tools, but actually creating them
in such a way that they allow consumers to engage and enhance
Hopefully, that detail can be built into future CAP work and next year’s health care reform debate.
Joshua Seidman is the president of of the Center for Information Therapy
that aims to provide the timely prescription and availability of
evidence-based health information to meet individuals’ specific needs
and support sound decision making.