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Concrete details have more influence: Massive healthcare reform looks good on TV, but one-piece plans work better in real life


Typically not a big fan of movies, I was surprised by how much I enjoyed my DVD rental of "Man of the Year." The basic premise of the movie has a quirky, independent-party candidate winning the popular vote in a presidential race.

In one of the most memorable scenes, the character goes on a lengthy tirade during a televised debate, revealing how he truly feels about one particular issue. I wish real televised debates included that kind of integrity.

There's much at stake for healthcare with this upcoming election, and we shouldn't settle for simple rhetoric in the months ahead. So far, the 2008 candidates seem to be offering similar visions for the future of healthcare in America, and some of their ideas appear to cancel each other out. I looked at the Web sites for the strongest contenders, and I found that most noted some points about healthcare but nothing that really got my attention.

In his letter, Grove tells those seeking election that they should scale back their grand plans for curing every healthcare challenge in one fell swoop because historically speaking, fundamental changes have never been all-encompassing. Instead, they've happened step by step. He suggests that they should commit to two specific issues that can be early wins.


The first issue is the emergency room situation. Too many people use the ER as a default healthcare system and 24-hour physician service. Grove proposes that hospitals should create on-site walk-in clinics, staffed with primary care professionals who treat nonemergencies, supported by a simple electronic record system. Fund them with a 1% surtax that would be distributed to ERs that comply, he writes.

Second, use remote monitoring and other solutions to delay or avoid seniors' moving into nursing homes. Keeping 10% of aging Americans in their own homes can amount to $30 billion in annual savings, according to Grove.

He believes this country can afford those two comparatively small changes and writes, "not making these reforms would be the same as burning $30 million a day at the local dump."

Having spoken in person and at length with Michael Howe, the CEO of a walk-in clinic brand (See Executive Profile) and Dave Schmidt, the CEO of a Medicare plan that aims to keep seniors in their homes, I believe that Grove's ideas could work. Even if the two changes only add up to modest savings, they're certain to improve quality of life. Maybe healthcare leaders and our 2008 candidates should consider Grove's scaled-down model. I'm sure the big reforms will come eventually, but there's a lot to be said for the early win.


I might have to go out for another movie this weekend, although it's not one I really look forward to seeing. Michael Moore just released his new movie about healthcare, which most likely will have the deck stacked against commercial plans and drug companies. Just a hunch. Consumers tend to take his material with a grain of salt, but you might be hearing from some of your customers who were influenced by it. Let me know if it becomes a topic of discussion within your organization.

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