It is unfortuanate that a lot of mud is being slung in every direction and it is hard to understand the truth. My dad used to say there were three sides to every argument: yours, mine and the truth. Okay so whatever; how do we peacefully move forward from here?

Let me pose an idea as a way out for everyone to save face and help the nation keep moving forward in a progressive manner towards a better health care delivery system. Let’s move our dialogue and focus on Evidence-based Policy so that we can cautiously and confidently transform our health care policies, delivery system, legal ramifications, etc. What does that mean and how does it look?

Massachusetts mandated that everyone obtain health care insurance coverage in 2006 and have about a 98% compliance rate although this rate is falling because of the economy. Recently, the state has requested that they be free from Medicare & Medicaid guidelines in order to move towards a per person / per month reimbursement model. Sound like an HMO - yes but the reason it could be different than the HMO’s of the 90’s is that there could be no ‘cherry picking’ or denial of individual coverage. Cherry picking by insurance companies was associated to the failed governments attempt at HMO’s in the 90’s (otherwise known as Medicare Part C).

Anyway, it seems we would have a greater chance of success with national health care reform if first focus on a pilot state. If the federal government worked with Massachusetts focusing on their cost over runs, examining the benefits of individual reform components that would greatly improve our health care system. These include:

1. Per person / per month reimbursement model to reduce wasteful paperwork and provide more physician to patient time (currently less than ten minutes per visit).

2. Tort reform which has helped to reduce insurance cost in the states of Texas and Ohio.

3. Transparency of information: total costs and patient out of pocket fees before expenses are incurred; provider report cards (performance evaluations) in consumer friendly formats; easy and complete access to evidence-based treatment protocols, etc.

4. Create equality for obtaining health insurance regardless of how it is bought. This could look like State Tax incentives for obtaining health care insurance and also taxing employer based insurance (over the equivalent tax credited amount).

And that calculation does not include any consumer behavior change based upon the policy changes which seems like a glaring flaw. After all, the stock market is so fascinating because of the psychological response to news, etc. that causes massive fluctuations. Investors are consumers of health care too; consumers will have psychological responses to any health care reform put before them.