In the cacophony of criticism and crowing as to who is right and who is wrong following the opinion of the Supreme Court on the Affordable Care Act, I offer a still, small voice to note that, actually, both political parties – and the Court — are right … in part.
First, Democrats are right in that something must be done to contain health care costs. Double-digit increases in any line of a budget or a business’ overhead are simply unsustainable. These startling increases in health care costs are unacceptable drags on the American economy.
The presence of these increases in your health insurance bill generates the assumption that the industry is over-charging.
In the interest of full disclosure, I have the honor to head up one of the best health plans in the country. We are a non-profit company that manages to a margin of 1-3 percent. By definition, if our margin is 1 percent that cannot be the cause of a double digit increase.
In fact, dozens of factors prompt health care cost increases. Some of these are good, such as new drugs to control cancer or innovative surgical procedures that turn a three-day hospital stay into an outpatient visit. Some of these are not-so-good, such as the cost-shifting of the uninsured and government programs that underpay hospitals and doctors, which raises prices by up to 30 percent. Because the problem is compound and complex, any effective solution is intricate. Democrats are right that any effective solution requires all of us to be a part of a system.
Second, Republicans are also correct, in that the most effective solution to the problem of spiraling health care costs is NOT a partisan piece of legislation, driven through Congress without a single Republican vote. Now, truth be told, there is blame on both sides of the aisle for this partisan divide. The fact remains that a purely partisan Act of Congress is a terribly unstable framework for a long-term solution.
Republicans are also right that any solution requires more than a mandate; it requires rules that address market realities and individual choice.
Lastly, the Supreme Court was also right, in its decision not to intervene in this political process, appropriately noting that “it is not our job to protect the people from the consequences of their political decisions.” In other words, having elected a President and a Congress, we should not be surprised that we get a health plan that implements their vision. The appropriate response is not to look to the Court for a policy more to your liking; it is to strive for a different outcome in the next election. The Supreme Court consists of nine judges who determine the constitutional parameters within which government must operate. They are not nine philosopher-kings (and queens) who set health care – or any other – policy.
Notwithstanding the correctness of Democrats, Republicans, and the Court on these issues, there is one truth that none of them has said: ideology will not lower the costs of health care. Higher quality care that leads to better outcomes, better access, and superior coordination of care are the ways to do that.
Our system inWestern Coloradoalready does those things pretty well compared to other parts of the country. However – as any business or household inGrand Junctionwill tell you – we have not built a system with low costs. In fact, no community can build such a system in isolation. It requires coordination between the health plan, the federal government (which writes the rules for Medicare), the state government (which writes the rules for Medicaid), the medical community, and each consumer.
We do not do that perfectly here. We just do it better than most other communities. This ability to collaborate is not surprising. It is in theDNAof manyColoradocommunities to approach difficult issues collectively, as a community. From allocating water in a draught to fighting fires, to getting a school district budget, to the JUCO tournament inGrand Junction, we address problems best by working with each other. This is our Western heritage of caring about each other.
Over the years, our cooperation has led to a high performing health system admired by both sides of the partisan divide. Democrats can look toGrand Junctionand value the broad access to mainstream care for the poorest individuals in the community. Republicans can look toGrand Junctionand see a private-sector solution, based on individual choice.
All this creates an opportunity for us be part of our country’s larger solution, and there is a concomitant obligation for us all to rise to the occasion. In communities like Grand Junction and Montrose, we should make the effort to help turn down the heat and turn up the light. What the country just might see is a better path to high quality health care that is both more accessible and more affordable.