Health Care Reform: Your view depends on where you sit

Remember the story of the six blind men in India who went to see the elephant? They each came upon a different part and their descriptions, while accurate, never told the whole story.

The first approached the elephant and upon the beast’s side he happened to fall, “God bless me! But the elephant is nothing but a wall.” Said the second who came upon the tusk, “Ho what have we here? Tis very much like a spear.” And the one who felt about the knee, “Tis clear enough to me; the elephant is very much like a tree.”

And so these six different men “disputed loud and long, each in his own opinion, exceeding stiff and strong, though each was partly right, and all were in the wrong!”

In the past several weeks I have had occasion to speak with hospitals, doctors, patients, business owners, insurance agents, city council and county board members, teachers and school superintendents and many people without insurance. There is wide agreement that problems exist. But perspectives differ on both the problems and the solutions.

Patients see large medical bills and more costs out of their pocket; business and local government see unaffordable premiums; state government knows health care takes up more of the budget; insurance companies see unhealthy habits among the lives they insure and hospitals and doctors see an incredibly inefficient mound of paperwork.

The senators are not immune from the elephant syndrome. Senators who represent Madison and Milwaukee see large HMOs and say “this is what we want for the state.” The rookie state senator from Alma says “Wait! That will never work in Waumandee!”

Despite the difficulties, we are moving forward. Although the details are complex and the solutions involve changing the way we do things in health care, there is a sense of urgency that something must be done soon.

We all agree that we must cover everyone; costs must be controlled and we must preserve and encourage high quality health care. Senators are debating the details of how to accomplish these goals within a state budget that already faces a $1.6 billion deficit. No small task.

The medical field is moving toward a system that more clearly defines quality and standards for care. This is helpful because the standards also include the cost of care. One example is giving aspirin to those at risk for a heart attack. It is cheap and we know it works.

Doctors face a challenge keeping up with the medical science. More than 10,000 randomized trials are published annually. Providers need professionals to sift through the studies and develop guidelines. We know medical practice can vary widely – affecting patients’ health as well as unnecessarily increasing costs. Providing guidelines is a way to cut costs and keep quality high.

Medical errors, perhaps from poor handwriting, are another source of poor quality and high cost. Electronic medical records are way to reduce errors and share records between big city hospitals and rural clinics.

Details on organizing the system are particularly sticky. Some have argued that networks of doctors and hospitals working together are the most efficient way to provide care. Others people, especially small rural providers, worry that larger health care systems will force them out of business.

Like the blind men of India, disputes describing the health care beast continue around the state.

Meanwhile, we are quietly working on a solution. Listening to the stories is important. And today I will be attending another public hearing in Kenosha. The step we must now take is to view the whole elephant and to agree upon a plan for reform, knowing that we will not please everyone. We will need to put partisan differences aside and work together to find a solution. No easy task for those people so used to divisive campaigns. We will need the Wisdom of Solomon to bring the plan forward through the legislative process and to the governor’s desk

If you have thoughts on school funding or any other state related topic, please call or write: in Black River Falls at (715) 284-1730; In Eau Claire at (715) 838-0448 or in Madison at (877) 763-6636 (toll free); or write: State Capitol; P.O. Box 7882 Madison, WI 53707-7882 or email Sen.Vinehout@legis.wisconsin.gov.

And thanks to John Godfrey Saxe, the author of The Blind Men and the Elephant.