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Seeking solutions to America's health care crisis
The seeds of change for the U.S. health care system may have been sown in the Nott Memorial on a Friday night last October. That’s where a group of alumni friends—physicians, health administrators, college faculty, lawyers, insurance executives and nurses—heard from a leading health care reformer and began a weekend symposium aimed at creating guidelines for improving what they called a system in crisis.
The event was the second in the Alumni and Friends Symposium series supported by College Trustee Nancy Eppler-Wolff ’75 and her brother, David Eppler ’82. The three-day event produced a detailed report and memo sent to U.S. Sen. Charles Schumer, D-N.Y., and to members of President Barack Obama’s administration, who last fall targeted several health care reforms in their campaign platform.
“First, it was unanimous that the status quo is unacceptable and the current path is untenable in the long run,” reads the report generated by the symposium. “Health insurance is the fastest growing cost component for employers. Premiums generally increasing at twice the rate of inflation put an undue burden on both American workers and businesses. Clearly health care reform must be a part of any long-term solution to our economic problems and international competitiveness.”
Dr. Ezekiel Emanuel, chairman of the Department of Bioethics, Clinical Center of the National Institutes of Health was the Friday night keynote speaker. Emanuel is a breast oncologist and the author and editor of numerous books, including Healthcare Guaranteed and the recently published Oxford Textbook of Clinical Research Ethics.
In January, he was named as a health care expert in the White House Office of Management and Budget. His brother, Rahm Emanuel, is President Obama’s chief of staff.
During his speech at Union, Emanuel outlined a comprehensive tax-supported universal health care plan in which Americans get vouchers to buy basic health insurance coverage, with additional vouchers offered for advanced care. The plan keeps insurance companies in place and shifts costs of health care away from employers.
“This system is much more likely to emphasize primary care doctors. You are likely to see health care plans pay more to primary care doctors and less to specialists,” Emanuel said. “Pediatricians, psychiatrists, internists and family practice doctors are likely to get a much better deal in this system. In the current system, it is true that most American docs are very unsatisfied.”
The symposium’s second day of events featured Timothy E.Quill, professor of medicine, psychiatry and medical humanities at the University of Rochester Medical Center. He talked about end-of-life care in a discussion moderated by Carol Weisse, professor of psychology and director of Health Professions Program.
Throughout the weekend, guests participated in a series of workshops aimed at defining problems facing America’s health care system and proposing solutions. Part of the symposium’s goal was to help graduates re-engage in the intellectual life they enjoyed at Union, said political science Professor Terry Weiner.
“Union should be part of a continuing intellectual stimulation; an intellectual and professional growth through a lifetime. Hopefully these seminars will allow alumni and friends to renew the intellectual experience they enjoyed at Union and think about important issues,” Weiner said.
The first Alumni and Friends Symposium, held in June 2007, was modeled after the “Moral Dilemmas of Governing” class led for many years by Byron Nichols. Twenty former students of Nichols, a popular political science professor at Union from 1968 to 2008, returned for a spirited discussion on the moral and political issues surrounding illegal immigration.
Both symposiums have been aimed at providing impactful suggestions for changing faltering federal systems.
“Symposium members generated a compelling set of guidelines that focus on issues of cost control, prevention and equitable care. I hope that our state and federal officials will use these guidelines wisely to help guide their own thinking about these difficult issues,” Eppler-Wolf said.
Guidelines for change:
Major points from the symposium letter sent to Capitol Hill
• The status quo is not an option. Reform is critical to promote recovery and expand coverage to all Americans.
• We must not only guarantee universal access, but equally important is controlling costs and improving quality.
• The current link of health insurance to employment is costly to employers and expensive to administer. Plans that break that link are to be preferred.
• Reform must place a renewed emphasis on primary care and prevention as the best strategy to improve quality and reduce cost.
• To gather the support of physicians and improve the morale of the profession, malpractice reform should be addressed and not postponed.
• Whatever system of financing and delivery is ultimately chosen, care must be taken to structure incentives that match the goals of the system such as adjusting reimbursement rates to reward primary U care and prevention
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