Friday, March 27, 2009

Health(Car)e Talk

I didn’t get called on at the regional White House Forum on Health Reform in Des Moines this week, and it’s my own fault for not waving my hand more aggressively. I stewed about it for awhile, because no one mentioned women’s reproductive health or pregnancy prevention, and that’s what I was there to talk about.

The next day on NPR I heard that no insurance representatives were called on either.
This was not a slight for them or me; it’s just that there were over 500 people in the room and most of them wanted to talk.

The more I thought about Nancy Ann DeParles’s parting words, the more I realized that my role might have been to listen. As the White House Healthcare Reform Czar, DeParle recapped what she thought she’d heard. She suggested that in other attempts to reform the health care system in this country, stakeholders came to the table with a perfect plan, and when their perfect plan wasn’t adopted, they chose to stick with the status quo rather than compromise. What she thinks she’s hearing now is that people are willing to listen and willing to create a not-so-perfect plan, then work to make it better.

In the course of the forum, I re-crafted what I wanted to say if I had the chance. Then a guy stood up and said that he’d heard a lot of representatives of various interests talk about how they wanted to be “at the table” when decisions are made, but that wasn’t why he was there. He wanted to suggest a solution. I decided to listen more carefully.

Yes, I want pregnancy prevention to be part of the conversation, but I was impressed by the eloquence of the head of the nursing association. I was moved by the president of AFSCME who said home health care workers who toil all day helping our most vulnerable elderly citizens can’t afford health insurance. By listening I better understood the enormity of issues facing us and the necessity of compromise.

I know the squeaky wheel gets the grease, but I know also that a car is the sum of its parts, and any vital part that malfunctions means the car isn’t going anywhere anytime soon. So the forum was a valuable opportunity to stand around the car, expounding on its imperfections, peccadilloes, flawed design and how this part or that could make it better. But, in the end, a team of mechanics is going to have to get under the car and get dirty fixing it.

After we’ve had our say, we need to listen to the dialogue between Congress and the Administration and if the vehicle runs when they’re finished, we need to test drive it even if it sputters a little. We can always take it back for a tune up.