In our business, the greatest risks and opportunities that we experience are due to the major changes in the industry we serve: healthcare. It’s with this in mind that I’m attending the World Health Care Congress in Washington, D.C. this week.
Personally, I’ve been surprised at how aggressively the Obama administration has proceeded with a dialogue on healthcare reform. I truly believed this topic was too politically charged to deal with so early in the term. Clearly I was wrong.
The opening panel this morning examined the issue of achieving universal health coverage from three perspectives: the new administration, the California experiment that has failed to pass and the Massachusetts framework that is now providing coverage for nearly 98 percent of its residents.
Jon Kingsdale, the Executive Director of the Commonwealth Health Insurance Connector Authority, talked about the Massachusetts approach, which really resonated with me. The other panelists discussed the principles that the administration has for its future plans as well as California’s need to pass legislation with bipartisan support. However, Dr. Kingsdale took a very different approach – he addressed the question of “What is the path from A to B?”
The vision shared by most advocates of universal coverage is that the costs of increased coverage can be offset by cost savings elsewhere. The approach taken in Massachusetts bites this off in pieces, and this staging of reform is the secret to their success.
The challenge of cost cutting is that one person’s costs are another’s income. So, how is Massachusetts approaching this?
1) Go for universal coverage first
2) Attack costs from a position of defending what has been achieved; the moral high ground that provides strength
Staging reform made this palatable in Massachusetts. That’s the difference between vision and strategy; it is the ability to execute.
The approach taken in Massachusetts is risky in many different ways. It’s a gamble. Truth be told, Massachusetts has only executed step one, and not step two. They are tackling step two now with a good plan. But they may fail. So the uncertainty is if they fail to achieve the cost savings, how long will they be able to afford to maintain universal coverage?