Health Care: Paging Dr. Reform

WaPo columnist David Ingnatius thinks that health insurance reform will "only make things worse" without health system reform.

Forgive the analogy between war and health care, but maybe Obama needs the medical equivalent of a Gen. David Petraeus -- that is, a professional who can break through the political chaff and describe a strategy for reform that can unite the country.

I have a nomination for the medical commander role, and it won't surprise anyone who follows this issue: Dr. Denis Cortese, the chief executive of the Mayo Clinic. He's already doing what the nation needs -- that is, providing high-quality health care at relatively low cost. Every time I listen to Cortese explain what's wrong with the system, I have the same reaction: Let him and other smart health professionals lead us out of the political morass.

Talking to Cortese this week, I heard two themes that cut to the heart of the debate. First, he thinks Obama has made a mistake in moving toward the narrower goal of "health insurance reform" when what the country truly needs is health system reform. Imposing a mandate for universal insurance will only make things worse if we don't change the process so that it becomes more efficient and less costly. The system we have is gradually bankrupting the country; expanding that system without changing the internal dynamics is folly.

Second, Cortese argues that reformers should stop obsessing over whether there's a "public option" in the plan. Yes, we need a yardstick for measuring costs and effectiveness. But we should start by fixing the public options we already have.

The rest of the story: Paging Dr. Reform by David Ignatius (Washington Post 2009-08-20)