Robert Blendon: Forget About Finding A Perfect Solution For Health Reform
In a fascinating interview published on Maggie Mahar’s Health Beat Blog, Robert Blendon, professor of health policy and political analysis at Harvard’s Kennedy School of Government, had some sobering words for those seeking radical reform of the health system. Blendon is well-known in health policy circles for tapping into the American mindset regarding reform.
First, Blendon looked at the current status of Massachusetts’ plan to cover the uninsured. Policymakers hoped that more than 220 thousand uninsured citizens would sign up for a heatlh plan. To date, only 15,000 have enrolled despite the threat of a fine. Blendon described the Massachusetts effort as “the canary in the coal mine,” . . . if it’s not breathing in 2009, people won’t go in that mine.”
Following are a few excerpts from his interview, which I believe are instructive.
Include All Relevant Stakeholders In The Conversation
“Reformers need to ask ‘what are the points that are absolutely critical to various interest groups if we want them to find reform acceptable?’ You want many people to feel that they have had a major say. Then they should develop a very general plan.”
Don’t Try To Be Perfect The First Time
“The very best plan for reform would be polarizing . . . Every interest group would oppose it, and it would never pass. What reformers need to do is to decide which groups they can bargain with. In Massachusetts they decided they could make a deal with the insurers. But reformers will need to work quietly behind the scenes . . . finding concessions they can live with—or fix later.”
Remember, Middle Income People With Insurance Are Risk Adverse
“Middle-income people with insurance are risk adverse . . . Legislators need to be very careful about how they try to re-arrange coverage for the middle-class. Even if these people say they are dissatisfied with the present system, they think they have a lot to lose—especially if they haven’t been seriously sick and tried to actually use their insurance.”
Maher’s post has ignited quite a debate and is fascinating reading.
November 15th, 2007 at 1:18 pm
[…] Robert Blendon: Forget About Finding A Perfect Solution For Health Reform In a fascinating interview published on Maggie Mahar’s Health Beat Blog, Robert Blendon, professor of health policy and political analysis at Harvard’s Kennedy School of Government, had some sobering words for those seeking radical reform of the health system. Blendon is well-known in health policy… […]