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Achieving Consensus

Posted by: Ron Pollack, Executive Director of Families USA on Mar 31, 2009

For decades, efforts to reform the health care system in this country have fallen to the opposition of special interests. When it seemed possible, or even likely, that health care reform would be taken up once again in 2009, we were determined to make sure that this wouldn't happen again. That's why Families USA joined a diverse group of stakeholders to determine if common ground could be found in a process called the Health Reform Dialogue. The goal was not to try to reach agreement on all areas of health reform, but instead to open up a dialogue.

The process - called the Health Reform Dialogue - involved groups representing consumers (AARP, American Cancer Society-Cancer Action Network, Families USA), businesses (Business Round Table, NFIB, U.S. Chamber of Commerce), insurers (AHIP, and Blue Cross/Blue Shield Association) physicians (AMA and American College of Physicians) public health professionals (American Public Health Association), nurses (American Nurses Association), hospitals and health care provider organizations (AHA, Catholic Health Association, Federation of American Hospitals, Healthcare Leadership Council, PhRMA, and AdvaMed).

Last week, we reached an agreement. The common ground we reached in this process is substantial and unprecedented - indeed, even historic. Never before have organizations as diverse as these achieved such a significant consensus, and this augers well for enacting real health care reform this year.

While some issues were more contentious than others, all of the groups agreed that covering all Americans should be a top priority for reform. The group proposes expanding coverage by building on the two pillars of health care today: public safety-net coverage and employer-sponsored insurance. First, we propose that Medicaid eligibility be expanded to cover all adults at or below the federal poverty level. Currently there are millions who are penniless who are not eligible for Medicaid. Second, we support the delivery of significant sliding-scale subsidies to make coverage affordable for middle-class individuals and families, and additional subsidies to small businesses to help them provide coverage to their employees. 

Other key components agreed upon by the groups include the creation of insurance market regulation designed to prevent denials or unfair discrimination in coverage based on medical history, pre-existing conditions, age, or other factors and to establish a fair and transparent marketplace for all purchasers.  We agreed as well to changes that will help lower costs, such as investing in comparative effectiveness research, health IT, and better preventive care.   

This dialogue is an indicator that the outlook for health care reform in 2009 is drastically changed from previous failed reform efforts, where different interest groups refused to find common ground. With this dialogue, we have begun building the bridges necessary to achieve meaningful health care reform.