Health system reform, when framed as controlling costs and improving quality, stands a better chance for increasing bipartisan support than framing it as increasing access to care. The recently passed health care reform package included a modest focus on the former, but clearly most of the attention – and certainly the money – focused on the latter. This is a chief reason why the debate was so acrimonious.
Whether you favor health care reform through market forces or some type of single payer or similar systems approach, both depend on the availability of reliable and transparent information on quality and cost for both buyers and sellers. If Arizona were to focus on collecting, analyzing and disseminating this information, perhaps we could bridge our ideological differences and be a trendsetter rather than a laggard in real health care reform.
The recent experience of the state of Minnesota is instructive. Over the past several years they have passed legislation directed at statewide measures of quality and the creation of an all-payer database, a provider peer grouping system, new ways of paying for care, and promoting health care homes. Most of this is voluntary, and clearly there are challenges, but they have achieved an impressive measure of bipartisan leadership and support.
Bipartisanship doesn’t just happen. Leaders work on working together. There are lessons here for Arizona.