As Congress returns to Washington, the health reform debate enters its most critical phase. After a "summer of discontent" revealing concern among many Americans for what is being proposed, President Obama seems to have lost the momentum that he had before the August recess. His plan to address Congress is a good starting point to regain momentum, but he need to do more to remind Americans why -- just as recently as May -- more than half of them supported health reform. His address can only be the beginning if he wants to succeed in passing a reform bill.
While the summer has been all about the sensational, the scandalous and the ideological, the fall must be a time of substance, centrality and pragmatism. Recognizing the political challenges of passing a comprehensive bill by December, he must seize on those consensus issues that -- in survey after survey, and statement after statement -- the vast majority of Americans say they want their government to do something about.
And he must clearly communicate to Americans how measures in current bills will address their concerns and improve upon what they have today.
In particular, he needs to reach out to the 85 percent of Americans with health insurance coverage and remind them about the risks of maintaining the status quo. Health care costs are growing so quickly that we must make changes to stem the growth -- otherwise, neither as individuals or a nation, insured or uninsured, will we be able to cover our health care bills.
The question is what policies under consideration do the vast majority of Americans view as being "worth" the investment -- not just tomorrow, but today.
The answer that tops the list is prevention. Americans are literally sick of a health care system that doesn't improve health, but instead waits until we get sick before it springs into action. That's why policies that will reorient our system to emphasize prevention is an idea that ranks at the top of what Americans want in health reform -- well above ideas that get a lot more attention from politicians and the media. In fact, according to a recent Trust for America's Health survey, Americans rated prevention as the top priority in health reform, above providing tax credits to small businesses and prohibiting health insurers from denying coverage based on health status.
In this highly politicized debate, it's important to note that a vast majority (88%) of voters -- Republicans and Democrats alike -- favor such an approach to reform, according to a recent survey by bipartisan pollsters Celinda Lake and Bill McInturff. For instance, there is strong bipartisan support for policies that make it easier for Americans with chronic disease to appropriately manage their conditions and prevent complications -- such as eliminating co-pays and deductibles for treatments for chronic illness -- which are a part of current reform proposals.
Policies to improve coordination of care, and prevent complications from illness and hospitalizations, also enjoy bipartisan support.
In Medicare, where -- quite literally -- all (99%) of our spending is linked to patients with chronic illness, there is ample opportunity to make a dent in cost, and improve the health of beneficiaries, by enacting changes to reduce complications and limit hospital readmissions. Up to 20 percent of Medicare hospital admissions result in readmissions within 30 days at an annual cost of $15 billion, of which $12 billion is potentially avoidable. And this is not rationing -- these are admissions and readmissions to hospitals that could have been prevented in the first place through well-managed and coordinated plans such as those at Gunderson Lutheran Health system in La Crosse, Wisconsin and the Mayo Clinic in Rochester, Minnesota.
Americans also want policies that increase support for coordination of care outside the hospital, and that strengthen the primary care network. Three-quarters of voters support better coordination of treatment by establishing personal medical teams of health professionals coordinated by a family doctor.
To further improve coordination and continuity of care, Americans favor enhancing the availability of patients and providers to access "real time" information. Nearly three-quarters (73%) support the development of a national health information technology network of electronic medical records. Not only would this reduce common medical errors that lead to additional illness and in some cases death and drive up costs, it would eliminate our reliance on our current paper-based system that leads to inefficient, fragmented care and produces waste.
Such common sense reforms will go a long way toward fixing the problems that Americans see every day in our health care system. This, of course, leads to the ultimate goal of what we need our health care system to deliver: better health, an improved quality of life and more affordable care.
President Obama certainly faces an uphill battle along the road to health reform. But as long as he advocates for those things that Americans, from all sides of the debate, believe are worth investing in, he will find he has a lot of company along the way.