Robert Fromberg
Editor-in-Chief, HFMA
“Yet we cannot truly carry out these responsibilities unless the ultimate focus of our concern is the personal health of the individual human being. We dare not get so caught up in our systems and our strategies that we lose sight of his needs or compromise his interests. We can build an effective National Health Strategy only if we remember the central truth that the only way to serve our people well is to better serve each person.”
--Richard Nixon, Message to Congress, February 18, 1971
I have a bad habit of dragging Richard Nixon (or worse yet, some obscure member of his administration) into conversations on every imaginable topic. I’m not generally a fan of Nixon’s policies, but find him a fascinating figure. In this case, however, I believe the quote above is relevant.
A recent report on employer health benefits from the Kaiser Family Foundation told us that the rate of premium growth has slowed, but is still twice the rate of inflation and earnings growth. These findings illustrate, according to Foundation president Drew Altman, the “slow unraveling of coverage in the employment-based system.”
With that report still in my thoughts, I next encountered a very different kind of argument for healthcare reform on HFMA Views. “The Other Side of Health Care” by MarieAnn North tells the story of the author’s Canadian uncle, who during a visit to the U.S. required hospitalization. North tells the story of struggling to get access to speak with clinicians, being asked repeatedly for insurance information, and discovering missing portions of the medical record. But this story has a twist—North was able to get up-to-date information about her uncle’s condition not through the U.S. hospital, but through phone calls to the Canadian case manager.
The irony of this situation is painful, although not as painful as what North and her uncle were going through.
Which brings me back to Richard Nixon. The 1971 Nixon health reform proposal is dated, but in surprisingly few respects. Most of the circumstances making reform necessary are still in existence. And his proposal for “a comprehensive national health insurance program…in which the public and the private sectors would join in a new partnership to provide adequate health insurance for the American people” shares qualities with the recent Massachusetts program.
Yet, what I am most struck by is the combination of big-picture reform proposal and the last lines of Nixon's message to Congress, which urge us to be mindful that the goal of broad-based health system reform is the health care of individuals.
While it's hard to put a face on the millions affected by U.S. healthcare processes and policies, Nixon's juxtaposition and the juxtaposition of the Kaiser report and the story of North's uncle help remind me that each of these people is an individual, and that's the reason reform is needed.
