This is what's next
President & CEO, The Claflin Company
The Rhode Island Foundation has assumed a pivotal role in the wide ranging debate over the future of our health care system. Health care reform is one of the Foundations’s core initiatives, chosen as having the most potential to improve the well-being of our State and communities. Efforts to improve access and quality while reducing costs have come more sharply into focus as the result of RIF’s efforts.
As a business person in the State for many years, I have taken a keen interest in this debate and often contributed my thoughts on what I perceived as the most equitable and practical courses of reform. Not everyone has agreed naturally, but that is the nature of such a process, especially on the topic of reducing costs. Every dollar we spend, and we are spending more all the time, goes to someone who will defend that aspect of the system. This is understandable. The leadership of the Foundation has been a key influence in efforts to keep the discussion above the fray of vested financial and even some political or ideological interests. We must continue this discussion as a business problem with serious economic consequences for our State. We cannot acquiesce to the powerful inertia of a status quo where escalating costs would force more of our neighbors out of the system each year. Only an arbiter with the reputation and respect the Rhode Island Foundation has built over many years can facilitate such a difficult and potentially divisive process.
There are countless thorny questions involved in any attempt to streamline a system of the scale and longevity of our healthcare system. We need to examine the fundamental causes of high costs. Are we paying providers too much or do people simply use the system more than necessary? Do we even have the right number and type of providers? Does our system of getting private insurance through our employer really make sense, and if so, who is really paying for it, the employers or their workers? Do we even need insurance or should public programs like Medicare just be expanded? How would we pay for such a change? Are insurance and pharmaceutical companies too powerful politically? All of these and other questions many of you now have on the tips of your tongues quickly entangle into a Gordian knot of frustration, but we must continue to pick it apart. Leadership is the key to keeping all the key players at the table and the Foundation’s role in that effort is essential.
Rhode Island in many ways is a unique venue for empirical research on alternative models of population health, health care, and efficient delivery, but even here the conversation will not be easy and every suggestion will have opponents. Hopefully, by following the moral compass provided by the RIF and others, our progress toward a breakthrough will continue.