My pal Tom Lorentzen used to administer Medicare for the Western Region. Tom is a very sober and responsible political thinker who believes in solving problems from a conservative bent.
Today, he has a piece in the San Francisco Chronicle pushing a plan that would help Obama pivot away from his current disastrous health reform course, while also bringing help to people in need. From his column:
As a community organizer, it is odd that the president has overlooked an opportunity to establish practical and measurable objectives while leveraging a political consensus that already exists among conservatives and liberals. It is a doable approach and can be framed as a “national community-based health care system” modeled after our public libraries and public schools. These would be neighborhood facilities, but integrated with funding and other assistance from local, state and federal governments and the private sector. They are community clinics and health centers.
It isn’t new. The dreaded and heartless Bush increased spending on these clinics back in 2002:
This format already exists and can be expanded. In California, about 800 such sites provide primary medical care, including dental where possible. They serve both underinsured and uninsured. They do not turn away people. Just as public libraries were designed to increase access to information and public schools were designed to increase access to education, so have community health centers been designed to increase access to primary medical care. They strengthen communities and enhance community health objectives.
Nationally, there are about 7,000 sites that serve about 20 million people. The “Health Centers Initiative” of 2002 greatly expanded their numbers and capabilities. A 50 percent increase in utilization occurred between 2001 and 2006. They collaborate with schools, hospitals and other public and private entities to promote health literacy. The community-based model has proven its value, provides clarity of purpose, is consistent with traditional methods of improving access in the United States, is cost effective, and possesses an existing consensus of support in Congress in both parties.
Imagine being a poor single mother and your kid has a fever. You go to a local clinic at the mall and have him checked out for $15. Matched with ,say, vouchers to help the less well off pay for affordabe private insurance high deductible policies, community clinics could strengthen the safety net significantly without breaking the bank. In any event, they certainly beat Obamacre:
Comprehensive health care reform tries to do too much at too great a cost - just as in 1993 - and again seems likely to be rejected as uncertain, unclear and fiscally risky - but that should not be the end of it. We simply need to pivot and frame the subject more precisely within a clear and consensus-driven framework that already works. It is not perfect and will not solve all problems. But, it would be a beneficial step forward that could return a desperately needed sense of comity and common purpose to our country so badly hurting from the wounds of faction and rancor over this important subject.
Well said, Tom. Well said.
