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Tallon addresses health care reform

James Tallon offered what he termed a “sober assessment” of the state of health care in this country when the Harpur Forum met March 28.

Tallon, a former state assemblyman from Binghamton, is now president of the United Hospital Fund of New York and chair of The Commonwealth Fund, a foundation that works toward a high-performance health system. His talk was titled “Health Care Reform: Setting Up the Next Debate.”

Tallon said he respects the commitment and skill of the professionals in the health-care industry, but believes the system as a whole is dysfunctional. Other fields, he noted, have recognized that improved safety and quality result not from human perfection but from effective monitoring and well-designed systems.

Tallon believes Americans are tied to the existing health-care system both out of fear of the unknown and because of special interests. Something must change, he said, since health-care costs now take up 16 percent of the gross domestic product, roughly a third more than in other developed nations. Not only that, but the system offers poor results in terms of access and deviations from accepted standards of care.

“The gap between us and other industrialized nations is expanding … continuing a 40-year trend in which health-care expenditures annually outpace growth in the economy as a whole,” he said.

Why is that?

“We produce health-care services as capitalists,” Tallon said. “We’re organized to sell services and products, including insurance, at the best possible price and volume, while we consume and pay for services as very poorly organized socialists.”

He said the number of uninsured Americans keeps rising, as does the number who have inadequate coverage. “Uninsured people are sicker, they die sooner, they get treatment later in the course of a disease and they actually pay more for care,” he said.

While it’s not clear whether health-care reform will be a top priority for the next president of the United States, Tallon said, it’s interesting to note that Democrats and Republicans see the issues involved quite differently.

Democrats generally describe the goal as universal coverage; Republicans seek to make health-care more available within the existing system. Liberals often advocate a government-run, single-payer system, Tallon said, but Democratic Sens. Barack Obama and Hillary Clinton are both committed to building on the existing system.

“The real question may not be between the parties, but whether our national leaders have … an appetite for a centrist deal,” he said. “The oddity of this discussion is that Senator Clinton, Senator Obama, Governor Romney — not candidate Romney — and  Governor Schwarzenegger could all fit within the same health-care reform telephone booth.”

Tallon said the lesson from the last major attempt at health care reform, during Bill Clinton’s presidency, is that it’s a mistake to take on too many details at once. “We should limit and sequence our efforts,” Tallon said, advocating a pragmatic approach in which leaders think in the short term about coverage and in the long term about costs and quality.

“It is a complicated business,” he said in conclusion. “It is not – it is not — a mystery. We understand the forces quite well. We see the potential problems of failure to act, and there’s potentially a huge common ground in the middle of this debate for agreement.”

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Last Updated: 10/14/08