Wednesday, September 09, 2009

Margie's Health Care Reform Advice for President Obama

Language matters in leadership. Look at what has happened with President Obama’s use of the term “public option” for health care reform. Who would’ve have thought that hope and goodwill, the populace feelings that elevated Barack Obama to the American Presidency, would turn into fear and paranoia?

In Canada, people like Margie, who has lived many of her years without universal health coverage, knows what fear is. As a 5 year old, she watched her 8 year old sister die from diphtheria. Margie survived barely. Neither was denied access, as the incident happened in England. Back in Canada, it would be another 43 years before true universal health coverage was available to Margie and her family. In the interim, she and her husband paid full price, as you go, and later paid premiums to private health insurers to keep the costs reasonable. Her husband always managed to work out “deals” with hospitals to pay them back on a monthly basis after Margie’s hospital stays for childbirth. The financial costs for raising a family remain vivid in Margie’s mind. It was tough!

Fast forward to 2009, it is incomprehensible to Margie that the United States, one of the most innovative and entrepreneurial nations in the world, has a health “care” system like she experienced in Canada 40 odd years ago.

But, Margie is a political “junkie”, having studied political science at University (she graduated with her degree when she was 55!). After having watched closely the debates and the rhetoric, Margie has an idea.

Stop talking about “public option”. Start communicating the message that a system will be created to allow 47 million or so American citizens without coverage to buy into an “affordable option”. Assure the majority that has health coverage that nothing will change. That is, there will be nothing lost. Improvements will be made as is typical for any system. Life will go on as usual. No worries.

Well, Margie knows it’s not quite that simple, because the costs in the existing health insurance system are spiraling out of control. Critics worry about a “parallel” system competing with a “public option”. Margie thinks that sounds strange for a society that prides itself on competition. Whatever! Borrowing a phrase from the grandkids! Furthermore, how can coverage for 47 million more be financed?

Margie says: “One step at a time”. That’s how it was done in Canada. Tommy Douglas, who spearheaded the reform, started small---Saskatchewan. That “pilot” evolved over a few decades. It’s hard to implement full-scale change. Much easier to begin “where the love is”, learn as you go and, build “buy-in.

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