The noisy back and forth may have settled down for a while, but the debate over health care in America is far from over. Leaders in Washington still must face up to the fact that health care costs continue to rise at unsustainable rates, while Americans are less healthy than their peers in other countries. In 2017, party politics overwhelmed any possibility of progress toward improving our health care system in a transparent and bipartisan way. Expect the debate to revive again soon, because this is a problem that’s not about to go away.
But we firmly believe it’s also a problem we can solve if leaders will remove the partisan blinders that narrow their vision and block any hope of solutions. Away from Washington and back in the states, governors know that we can work across the aisle to increase value in our health care system, lowering costs while improving health. Over the past year, as two governors from opposite political parties, we have brought together a bipartisan group of colleague governors — most recently including Gov. Bill Walker of Alaska — to develop a blueprint for improving our nation’s health system.
We’ve been struck by the fact that other sectors of our economy have seen dramatic improvements in recent years, boosting quality and performance while significantly reducing costs. This is in sharp contrast to health-care spending, where costs have steadily increased, but outcomes have not improved. As we watch improvements in almost every other area of business and industry, why should Americans settle for less from their health care system?
As governors seeking solutions, we reject false choices that pit high-quality health care against reducing costs or individual accountability against our obligation to support those in need. We know that lasting improvements to our health-care system will require harnessing private-sector innovation and competition, and that targeted government action is justified. We should work together in a bipartisan, transparent and inclusive way to build on what we can see is working.
Based on these core beliefs, our bipartisan group of governors has identified key strategies that will improve health and lower costs. None is more important than paying for value instead of volume. Too often in our present system, doctors, hospitals and others get paid more when people are sick than when they are well. States are leading efforts to change this, increasing access to comprehensive primary care and eliminating incentives to provide unnecessary services.
We are already seeing evidence of better results, but government alone can’t solve this and the nation needs to wake up to unsustainable, rising costs of health care. We are encouraged to see major employers starting to demand higher quality at a lower cost, with companies like Amazon, Berkshire Hathaway and JPMorgan Chase partnering to find a better health-care model for their employees. States are doing this too for their citizens, implementing innovative value-based reimbursement models for their Medicaid populations and state employees. The more businesses who partner in this work, the better the results will be.
Consumers also need to take a more active role in transforming our health-care system. All Americans should have access to affordable, high-quality health care regardless of their age, employment status or financial situation. To achieve this, we must give patients the tools they need to make value-conscious choices, and encourage the private and public sectors to develop technologies that make this possible. A patient who needs a knee replacement should be able to choose the facility and doctor that provides the best care at the lowest price.
Governors are willing partners, but states can’t do this alone. As the debate over health care resumes — as it must — we sincerely hope that bipartisanship becomes the rule and not the exception in Washington. As health-care costs continue to rise, we will soon get to a point where the system is unsustainable. People will throw up their hands and say this doesn’t work anymore, and we’ll end up with an extreme response that stifles innovation and threatens the quality of care. As governors, we are ready to create a responsible roadmap that will lead us down a better path.
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