Sunday, February 1, 2009

How To Eat An Elephant


If you were king, or president, or governor or CEO... and you had a big problem that affected as much as a quarter of the people you were responsible for... would you choose a comprehensive solution that would take 10 years to implement, or... divide the problem up into 10 more manageable pieces so you could take some immediate action and solve it in 10 steps? There may not be a right or wrong answer - in fact, some will argue that a leader cannot and should not solve the problem at all.

Our new president and congressional leaders are faced with such a problem - as the healthcare crisis in America involves not only our neighbors in need of care and medicine (compassion)... but also every healthcare provider who is struggling to survive under the weight of provider services without reimbursement (sustainability). With votes being cast in the recent and upcoming days, healthcare policy is near the top of the list for President Obama and the Congress - along with every Governor and state government. The first big policy shift will be an expanded SCHIP program - to provide an additional $33 billion over 4 1/2 years to cover an additional 4.1 million children - along with the 11 million children already covered by the program.

While this still leaves tens of millions of adults and even children uninsured, maybe this is the way the Administration is planning to eat this elephant - one bite at a time - starting with children, then covering the parents of those children, and eventually filling in the remaining gap with a FEP (Federal Employee Program) - like solution and/or a significant funding for more FQHC clinics across the country. Where do you see this going? How would you chose to eat an elephant of this size?