Dennis Berens, CHL -- 1997When Dennis Berens received a call from Ezekiel Emanuel, a senior counselor at the White House Office of Management and Budget on health policy and the brother of White House Chief of Staff Rahm Emanuel, asking him if he wanted to attend the March 5, 2009 White House Forum on Health Reform, Berens, president-elect of the National Rural Health Association, eagerly agreed to attend the forum. The forum convened approximately 130 members of Congress, health care organization executives and community members to determine how to lower health care costs for everyone, improve quality and expand coverage for all Americans.
Since 1990 , Berens has advocated on behalf of Americans who live in rural areas, and calls his current work as director of the Nebraska Office of Rural Health,, “a mission – not a job.”
He strongly believes that change happens in communities, and that health reform will only be successful when citizens join together to identify common themes and advocate for change. “Real changes only come from the bottom up,” he says.
Berens encourages Community Health Leaders to meet with their fellow citizens and discuss the pieces of health care that are missing in and for their communities. He believes they should then provide a citizen perspective on health care reform to policy-makers.
Below, Berens discusses his thoughts on the forum.
What an honor to be part of the Health Care Reform Summit on March 5, 2009. The gathering in the East Room of the White House brought together the key members of House and Senate leadership who will address any health care reform bill created this year. Also included were representatives from most of the key health care stakeholder groups that should have an interest in the process and outcome.
President Obama opened the summit by noting that rising health care costs now threaten the foundation of our economy. Bankruptcies, caused at least in part by the costs of health care, now occur every 30 seconds in America.
The president said that by the end of this year, the American people and their representatives must figure out how to lower costs, improve quality and improve insurance coverage. He noted the four big issues, presently identified, that participants should help find agreement on: 1) modernization of the health care system and the investments needed to do it, 2) preexisting health conditions, 3) fraud and abuse within the system and 4) the creation of a fully transparent process for all people to see and understand.
“All voices must be heard and all options must be put on the table. There can be no sacred cows. Each of us must accept that none of us will get everything we want, and no proposal for reform will be perfect. But when it comes to addressing our health care challenge, we can no longer let the perfect be the enemy of the essential,” the president said.
Obama said his goal is to enact comprehensive health reform by the end of the year.
A brief summary of the Forum includes the following:
1. The consensus today is that we must accomplish health care reform this year in spite of the political obstacles we face.
2. Insurers have agreed that changes are needed and that they will work with us.
3. AMA and business are at the table.
4. Citizens and members present want more coverage at a better cost.
5. Some want to preserve the role of employers and their workforce wellness efforts.
6. The health care system must be simplified.
7. Investments at the front end are needed as we align our incentives and push for quality.
8. What public option is needed today and how do we address the choice issues?
9. Medical malpractice and preexisting conditions must be addressed.
As I look back on the forum, my thoughts center on several big and smaller issues and two words: protection and empowerment. Explore those words in your mind and then give some thought to the following issues.
First, we really are in a revolutionary time where we seem to have some consensus points to build on for health care reform. The revolution that I see is the shift from an assembly line industrial-age model to a knowledge-age model that emphasizes connections and coordination. How to make the transition seems to be the sticking point.
Second, the discussions centered on health care, but that really meant providing health insurance for medical care. We must find a way to integrate the prevention and care models that we know work. We are being asked to find a way to cover all of us.
Third, the discussions lacked any real ideas about how to involve citizens in this reform discussion. How do you get at cost and care issues without citizen involvement in this process?
Fourth, how will an employer-based health insurance model remain viable in a globalized world that is competing like never before on price? And how will we get an integrated care model put inside our insurance structures?
Fifth, how do we get all voices, especially those from isolated rural areas of our nation, involved in this discussion?
I invite all members of the RWJF Community Health Leaders and their stakeholders to think about how to give voice to the needs of our people and their communities.