What is We Can Do Better?
We are a group of everyday people demanding fundamental, sustainable solutions to important social problems facing Americans.
What is “your plan?”
We have two parts: one is to build and grow a grassroots movement, with people who can understand the nature of the health care crisis facing our state and our nation, and create demand for a health system that produces health, rather than solely looking for ways to fund more medical care within the current insurance model.
Second, we have the framework of a new health system – the key elements that have to be in place in order to move from the broken system we have today, to a new system that has everyone in, pays for the right things, including prevention and primary care, and uses our money smartly – focusing on services that show great return on investment. We don’t have to start from scratch but we do need to make sure we’re trying to solve the right problem. The question isn’t limited to how we pay for it. It is also asking about what we pay for, and how we can deliver care in the most efficient way that reaches everyone.
Are you talking about Socialized Medicine? Single payer? Universal health care?
We’re not talking about socialized medicine; we’re talking about civilized medicine. Besides, we already have a system of universal access – it’s called the emergency room.
Socialized Medicine is where the providers (doctors, hospitals, etc.) work for the government. And single payer refers to a streamlined way of paying for services. While there may be simpler ways to pay for services, the real issue is what we are buying with our money, in addition to how much money we’re spending.
At the end of the day, it is people like us who are the ultimate payer in health care, because that’s where all the money comes from. Government does not have money unless we pay taxes. Businesses don’t have money unless we pay for their goods or services. We don’t have money as individuals unless business and government are working well. We are all in this together.
Are you talking about the US adopting Canada’s, England’s, or some other country’s health care system?
No, we’re not trying to re-create what exists in other countries, but we certainly should learn from their experiences. We want a new health system based on our values, and achieving the outcomes we want, creating a uniquely American system that guarantees all Americans affordable, quality health care – a solution that invests in our country’s health while challenging us to take responsibility for our wellness.
How is this better than what was passed at the national level, or what’s being tried in other states?
No state alone can solve the national health care crisis. But states can and have taken on issues of trying to expand public programs and improve how care is delivered. But many of the laws and regulations that govern (or restrict) those actions are federal.
What states can do is push the debate and make it clear that this is a national problem that requires a national solution. Without elevating the debate above the question of how to pay for insurance, costs will continue to escalate. We have to go beyond putting more money into the current system; it’s not just how do we pay for it – it’s asking ourselves what we are buying and how those services can be delivered in the most efficient ways and result in improved health.
States are also the perfect laboratory for reform, able to innovate more quickly, because of relative size and governance.
What will happen to my insurance?
Your insurance coverage may improve, may become portable, or it may cover different things than it covers now. You might pay for insurance differently than you do today, for example through a health insurance exchange.
Whatever changes take place you should have an opportunity to compare it to whatever you have now. Any plan that’s developed should meet principles of equity, fairness and affordability. No one should be afraid of losing access to care because of a change in personal circumstances. Everyone would be “in.” The goal is for everyone to have access to a defined set of essential, effective health services – a core benefit. There may still be a role for private insurance, but the core benefit would be available to everyone.
What will happen to Medicare?
Those on Medicare today should be protected; whatever plan that’s developed wouldn’t make changes overnight.
There are 43 million people on Medicare today; 78 million people were born during the baby boom. The first baby-boomers have already hit Social Security and Medicare. There is agreement that without fundamental change Medicare is not sustainable. If we don’t do something in a planful, intentional way there will be reductions in benefits, increases in premiums and taxes or perhaps all of the above. Some of that is already taking place today – few primary care providers in Oregon will accept a new patient on Medicare, and many providers are asking existing Medicare patients to find new providers.
Why is this important to me?
We all pay for the current inefficient and outdated health care system – through taxes, premiums, and the rising costs for goods and services. We pay even more by accepting the growing number of people without access to health insurance as a fact of life, and by continuing to pay for services that do not result in improved health or quality of life.
If we don’t establish a new health system that is equitable, affordable, and sustainable, three things will happen: decreased benefits, increased costs, and increased out-of-pocket charges to individuals. We have to do this sooner or later. Let’s do it so we all benefit.
How much is this going to cost me?
Part of this question presumes that we know what today’s inefficient health system costs. Currently taxpayers subsidize health care for Medicare, Medicaid, and employer-based benefits. The central problem is not money, but how the money is being spent. Our tax dollars are not being spent wisely.
Experts agree that if we design a system that is efficient, and delivers services that are focused on optimizing health, that we have more than enough money today to provide health care for all. Quality affordable health care is an investment in our nation’s future, our children’s future.
This won’t happen overnight. It may take a decade to make the transition, and yes, we will have to make some investments in the short term in order to re-tool our current industries to meet the needs of the new system. But remember that the US spends more overall and more per person on health care than any other industrialized nation on the planet and we still have poorer health outcomes. There is agreement that we can spend our money more wisely and efficiently, leading to better health and control the rising costs of health care.
What will I get?
1) A successful health system that partners our own personal responsibility with a system that is affordable, equitable, and sustainable.
2) Assurance that a change in life circumstances will not leave you without access to needed effective medical care.
I’ve heard people say that everyone has access to health care now through the Emergency Room. Why do we need to create a new system?
Universal access through the ER is an inefficient use of highly trained clinicians and state of the art equipment and facilities. And not all communities have the same resources available. Our objective is to create a sustainable system that uses resources wisely, ensures that everyone has access to a defined set of effective, essential health services, and leads to improved health of the population.
Who is Archimedes, and why were you first called “The Archimedes Movement”?
Archimedes was a Greek mathematician and inventor. He invented the lever and is often quoted as having said “Give me a lever long enough and a place to stand and I can move the Earth. We here in Oregon have an opportunity to act as a lever and be the demand for fundamental change that can change what we achieve here in Oregon and how the nation goes about solving the health care crisis.
We were founded as The Archimedes Movement but after only a few months, changed our website to www.wecandobetter.org. In 2011, our Board of Directors voted to change our name to We Can Do Better.
It sounds like you want to have a government run system and I want to keep the government out of our pockets.
First off, when it comes right down to it, the government is us. That’s why our founding fathers wrote “we the people.” Our tax dollars go to pay for fire, state and local police and prisons, the FBI, CIA, Homeland Security, and our armed forces. We pay for roads, highways, libraries and schools. In other words, we pay for things that are important to us as members of a community, whether that’s local, regional or national.
When it comes to our security as a nation, it is the government’s role to protect us but they can only do that when we give them money to do so. Protecting the health of our population is at the heart of securing this nation so there is potentially a role for the government but how that role looks is not pre-determined.
I want a market-driven/free-market approach.
Private markets are an essential component of sustaining any plan, but we have to understand that markets are going to ‘follow the money.’ We have to realign incentives so that businesses want to invest in and accomplish things that will lead to improved health outcomes. We want the money in the right places, encouraging them to do the right thing. Right now they invest in things that are reimbursed – high tech, acute care – when our pressing needs are to improve the health of people with chronic conditions. We have to agree on what the purpose of our health system is; once we do that we can determine how to re-design the system to get us there.
The American Dream implies the promise of opportunity and upward mobility. Health is the first rung on that ladder of opportunity. A successful health system will incorporate personal choice and responsibility, and both public and private plans will have a role in moving us toward health care for all.
Are you talking about rationing?
Rationing is a way of describing and accepting limits. Health care is rationed today by leaving close to 50 million Americans without access to health care at all.
We must acknowledge that there are limits – there is only so much that the public will pay in taxes and fees. What we really need to talk about is what we should use public dollars for – the money we hold in common to support everyone. There is only so much that the public will tolerate in taxes, and therefore the necessary debate is to define the floor – that level of care that the public will ensure is available to everyone regardless of income. Defining the benefit then making sure that the benefit is provided in a high quality, efficient way using the best practices that are available.
Aren’t there more pressing issues like the economy and creating jobs?
There are a lot of issues facing us that will influence how we live today and the world we leave for our children and grandchildren. The truth is that they are all connected – we must have a healthy workforce in order for the economy to improve. We must understand how all of these issues are connected when it comes to health. We will not improve the economy by impoverishing a greater number of Oregonians. We will not fix the health care system by leaving more people without access to health coverage.
Health providers are often the largest employers, and in some communities are the primary employers. Companies that are struggling to stay open and sustain themselves are burdened by the rising cost of health insurance for employees. In order to solve the economic crisis we must also be making sure that we are investing money in the smartest, most efficient ways, getting the best return on investment. What better investment can there be than in the health of the population?
We don’t have the money to pay for universal access to health services. How can we pay for this?
Each dollar that Oregon spends from the State’s General Fund brings $1.60 of federal money to Oregon. So, that means that for every dollar we cut from the state budget, we actually cut $2.60 of services.
First off, in tough economic times, let’s not leave federal money on the table that we could be using to pay for care for Oregonians.
Second, we’re not talking about paying for more of the system that we have today and we are not presuming that the new system will cost us more than we’re spending today.
We are talking about finding money to build the system of tomorrow, one where everyone has access to the care they need, where we are paying for services that we know have a positive impact on improving health, and that is delivered efficiently. We are not presuming that will cost us more money, but we are saying we must spend our money more wisely than we do today.
We are used to doing more when we have more money and doing less when the economy isn’t as strong. It is time to figure out how to do better, whether we have more funds or fewer funds. We have to be better, smarter and accomplish the objectives of better health, better quality and controlling costs.
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