Last night Ted Cruz and Bernie Sanders stood together in the national spotlight and squared off about healthcare policy in the United States. Initially I found myself turned off by the debate, as I do not agree with the perspective of either Senator. And, like many Americans, I am tired of stump speeches and campaign rhetoric. Still, the topic is important, dialogue is welcome, and perhaps there is still light at the end of this showcase.
As an industry insider, I find it painful when I come face-to-face with the limitations that politicians often have when addressing healthcare. The industry is simply too complicated to fit into sound bites, and the explanations for how and why various policies are connected can make even the most earnest observer glaze over. While I am only a 7 out of 10 on the healthcare wonkiness scale, I found myself wanting to clarify or refute both Cruz and Sanders on various issues when they misfired.
Let's get real I also wish the Senators had conceded to each other’s intelligence rather than retrenching to their campaign positions. Sanders could have acknowledged that the majority of the Republican leadership does not intend to just decimate healthcare; they intend to propose an alternative. He may disagree with whether that alternative will achieve the stated goals, but it is unfair to tack the worst case scenario on the Cruz plan. And, Cruz homed in on challenges in the health industry, blaming them almost entirely on the Affordable Care Act (ACA) without recognizing that 1) these trends and challenges were in place before the ACA and 2) the ACA actually did make a difference in addressing some of them, even if he does not think it went far enough toward change.
This lack of acknowledgement to each other may be the very gap continues to frustrate so many of us about the healthcare policy debate. It would be great if Democrats would stop pretending that we can keep open a blank check funding Medicare and Medicaid without drastic negative consequences to our economy. In fact, lack of caps on public healthcare spending could be one of the root causes of healthcare inflation. The ACA may have been a first step at expanding access, but there will need to be some pain in spending limits before the industry will behave differently at scale.
It would be great if Republicans would stop suggesting that they are going to be able to immediately lower premiums significantly without scaling down covered benefits. Lower premiums come at a price; it's math. Also, the government has a large role in regulating healthcare, but in the current market-based health system the government is not deciding what healthcare people should receive. I have complete confidence that those in the industry of all political backgrounds are committed to a meaningful solution that helps the most vulnerable Americans and sets the industry on a course to stabilizing costs. We can only do this by being creative, by untethering ourselves from care delivery and financing models of the past, and by boldly stepping forward.
Leading with hope But then again, here were two Senators, in the national spotlight, taking on the issue to which I have committed my professional life. They presented opposing views, each making his own case, calling each other out, and wrestling with the issue. An entire 90 minutes on a major news outlet was dedicated to healthcare. This is good. Indeed, the best points in the debate were the small moments of playful interchange and points when the Senators sought areas of agreement or partnership. Perhaps it is not enough, but it is a start, and for this I applaud CNN, Senator Sanders, and Senator Cruz.
So, for this accomplishment, and in the spirit of telling cynicism to take a seat, I say: More of this, please. More debate, more conversations, more and deeper dives that rely on data and facts. Please, more attempts to find common ground, and more recognition of the human impact of healthcare policy. We need more honest acknowledgement of what is not working. And actual recognition of what is. We need to face that the problems in healthcare started before 2014 and involve more stakeholders than just politics. Let us all do more rolling up our sleeves to carve a solution that is uniquely American. And let's commit to one that is relevant by working with the building blocks we truly have. What did you think of the debate?