Richard L. Clarke

"Only in America is my story possible." This quote from then-candidate Barack Obama resonated with me as I watched him become the 44th president of the United States on January 20.

Millions of other Americans watched his swearing-in ceremony, and billions around the world heard his speech. Almost all interviewed on that day expressed high hopes for the new president and the prospects of dealing with the many challenges facing this nation.

During his speech, President Obama urged us to embrace "hope over fear, unity of purpose over conflict and discord" when dealing with difficulties. He also noted that the challenges we face are serious and many, and that they will not be met easily or in a short time span. But he also said, "[K]now this, America-they will be met." One challenge he pledged to achieve was "to raise health care's quality and lower its cost."

That achievement will be no small task. The U.S. healthcare system has escaped systematic reform for decades because our leaders have failed to choose hope over fear, and unity of purpose over conflict and discord. The team President Obama has assembled to lead systematic reform efforts appears to be up to the task-so I have high hopes.

Much has been written about what is wrong with our healthcare system-high cost, inconsistent quality, millions without access to insurance coverage. Although much is also right with what we do, the status quo is no longer a viable alternative.

Healthcare financial leaders have an important role to play in this effort. We can be a positive force for change by providing insights into the consequences of decisions on resource provision and use. We can be objective in the discussions about payment, incentives, cost, and financial impact. We can be part of the solution by helping to foster unity of purpose.

So as our elected leaders begin the debate about how to produce a sustainable health system that deals effectively with cost, quality, and coverage, my hope is that they will deal with differences honestly, pushing for a unity of purpose, reducing discord, and choosing hope over fear.

During his inaugural address, President Obama's words were hopeful and inspiring. My hope is that his words turn into effective action.

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