Health-care task force faces tall task
Pignanelli & Webb
What's the gossip regarding membership on the task force?
Pignanelli: There is much speculation regarding the hidden agenda behind the surprising structure of the task force, recently appointed by Legislative Leadership. Many of the lawmakers with a deep expertise in this area (i.e. Jim Dunnigan, Becky Lockhart, Michael Waddoups) were not selected. Apparently leaders wanted some fresh faces dissimilar from the health task force from several years ago. (The musing focuses on whether membership is a dynamic of the upcoming leadership elections.) The legislative juggernauts of reform, House Majority Leader David Clark and Senate Minority Whip Sheldon Killpack will lead the committee. However, there is some thought all the "newbies" will need to be educated, which could be a distraction from the important goals.
Webb: I have no gossip to report. Only confidence that legislative leaders appointed members of the committee who will be fair, objective, hardworking and courageous, and who will be committed to make substantive progress this year (and who can leap tall buildings at a single bound).
Pignanelli: Yeah, lots of butt-numbing meetings. The summer will be spent on the same deliberations that thousands have deliberated for decades: reduce costs, maintain quality, and increase access to medical services without greater government. A number of advocate organizations and special interest groups will be pushing certain elements of change. But actual reform will only occur if all shareholders have skin in the game. Clark and Killpack understand this, and have demonstrated a willingness to venture farther than most officials. The bigger question is whether the public, including the business community, is really ready for true comprehensive change. The health system is inefficient and expensive, but have these burdens reached a crisis level where leaders can successfully demand sacrifices from all sectors? Further, this is an election year compounded with economic fears, never fertile ground for political courage. My client (Regence Blue Cross Blue Shield of Utah) and others are hopeful for significant developments from the group. My heart is with them; but my head still wonders.
Webb: This is absolutely one of the most difficult public policy issues ever tackled by any group of leaders. Meaningful reform can't occur without pain, without winners and losers. All stakeholders will have to give a little (maybe a lot). But the alternative to aggressive action is nothing short of disaster. Current trends in health costs are simply unsustainable. Crisis looms ahead for individuals, families, small businesses, large businesses and, perhaps especially, government at all levels. Medicaid and Medicare costs are poised to absolutely destroy what little fiscal stability the federal government has.
So the stakes are terribly high for the legislative task force. The pressure is on. This can't be politics as usual. This may be the state's last best chance to really do something meaningful. Utah citizens, businesses, opinion leaders, and all sorts of associations and groups need to provide encouragement and keep the pressure on.
Thankfully, the task force starts on a solid foundation. An enormous amount of work has been done by the Legislature itself, by health care stakeholders, by business groups led by the Salt Lake Chamber, by nonprofits led by United Way, by the governor's office, and by the State Health Department. Utah is being encouraged by HHS Secretary Mike Leavitt, who wants to help cut federal red tape to enable a comprehensive solution. Utah can set an example for the rest of the country.
Principles to guide the task force have been established and proven. The end game — what needs to be done — is clear. The way forward has been mapped out. The task force need not spend a lot of time in philosophical discussions. A sense of urgency is mandatory. We need action, not talk. Highly substantive proposals must be prepared for the next legislative session in 2009, not five years down the road.
I am actually quite optimistic that significant progress can be made.
Will health care be an issue in the Utah 2008 elections?
Pignanelli: Expect to hear or read the following frequently this year: "(candidate) will work tirelessly to lower your health-care costs but maintain the quality we expect by (choose: restricting insurance companies or maximizing efficiencies) through (choose: market-driven action or public-private partnerships)." Because it is a cause du jour this season, campaigns will talk, or even offer plans, on the subject. But few, if any, will recommend massive modifications to voters' lifestyle or current involvement with the system.
Webb: I hope it will be an enormous issue. I hope voters at every opportunity will ask candidates what they plan to do about health costs, and encourage them to take action. I hope they will tell candidates how they are personally being impacted, how costs are rising, and how current trends can't continue. Citizen activism will make a big difference.
Republican LaVarr Webb is a political consultant and lobbyist. During the recent legislative session, Webb conducted some communications work for the Salt Lake Chamber on health-care reform. Previously he was policy deputy to Gov. Mike Leavitt and a Deseret News managing editor. E-mail: lwebb@exoro.com. Democrat Frank Pignanelli is Salt Lake attorney, lobbyist and political adviser. Pignanelli served 10 years in the Utah House of Representatives, six years as House minority leader. E-mail: frankp@xmission.com.
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