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Another Voice: Health care reforms need to be driven by foundational principles

By Dennis R. Horrigan

I think we would all agree that the political debate on health care reform lacks the key characteristic of simplicity. Policy and reform provisions need to be designed so we understand how they impact not only our families but our neighbors. The current reform package is loaded with fine print and is anything but simple. We need a set of overarching principles to guide us.

There are two principles that I believe are foundational to shaping national health care policy.
First is the principle of the “common good,” namely a reform policy that is beneficial for all members of our community.

This principle suggests that we need to focus our reform efforts on universal coverage and a common standardized set of essential benefits that provide coverage for prevention, early detection and treatment, and services to prevent long-term disability.

How will we know if the reform package is good? We will know the answer when we can say that “we’re all covered” and we have the security needed and realization that whatever services we need in the future will be there for us. State waivers to bypass essential health benefits will only provide short-term relief from premium costs that will eventually have to be reconciled.

The second principle that needs to guide health care reform is “solidarity.” Solidarity connotes unity and the spirit that “we are all in this together.”

We live in interdependent relationships with our local, state and national neighbors. Health and well-being are foundational to growth and sustainability. Many factors and circumstances impact our health status that are outside our control.

Inherited medical conditions and exposure to harmful environmental factors play a significant role in our health care status and associated burden of illness.

The principle of solidarity leads to the question of what kind of coverage we choose and the weight of the premium cost.

If our crystal balls and astrologists cannot predict what health care services we will need in the future, then our health care policy needs to be designed to protect our families and neighbors for whatever lies ahead.

If we value solidarity we need to focus on universal coverage and community rating requiring everyone to participate at the same price to all persons regardless of age and health status. Community-rated insurance aligns with the principle that we are all in this together and we all pay the same premium.

Any health care reform that leaves populations without essential coverage is inherently flawed and will not be long-lived. Community-rated insurance is also a stimulus to communities to form partnerships to improve the health of communities.

We are all in this together and I sure hope that our health care policies are not designed around “every man for himself.”

Dennis R. Horrigan is former president and CEO of Catholic Medical Partners and currently a health care consultant.

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