A leading U.S. expert on strategy has given the United States government a tick for its efforts to reform the country's healthcare system.
"In the context of the history, given the complexity and the political sensitivity of U.S. healthcare reform, I think we have to give the Obama administration a great deal of credit," Michael Porter said in a recent exclusive interview with Xinhua.
"Therefore, I have to give it above the middle score for the healthcare reform's effectiveness," said Porter, a renowned professor at Harvard University and an influential thinker on management, competitiveness and social problems, such as healthcare, the environment and corporate responsibility.
Healthcare reform has always been a political issue. The philosophical focus for Republicans is to reduce the government's role, to open up competition and to give tax credits to people who do not subscribe to or have access to healthcare through their employers. Democrats, on the other hand, want universal healthcare and guaranteed coverage, regardless of health status.
The Obama administration has "largely delegated the shape and character of healthcare reform to the Congress, which is such a complex body that has had its hands full just even getting to where we are today," said Porter,
who has dedicated the past eight years studying healthcare systems in more than 12 advanced countries.
The current healthcare reform process contains six steps, with the first five the responsibility of the House of Representatives and the Senate to each pass their own bills, which will then be presented to a conference
committee to finalize into one bill. The last process is for President Obama to sign the bill.
So far, the House has finished the first three steps and the Senate has only finished the first one and a half steps.
The Obama administration should be much more involved in "guiding the process, setting down principles, and then negotiating directly with the Congress" on how to design the specific legislation and get the reform done, Porter said.
In his view, "we will be better off in terms of reform progress in the next two years, but worse off in terms of cost," because we are going to add a lot of new people into the system, without changing the system.
Porter added that the most important part of the reform was to change the nature of insurance competition, so that insurance companies could no
longer make money by practices such as excluding sicker people and changing the price when somebody gets sick.
He believed this change could have a "potentially revolutionary impact" on the capacity of the system to move to the next level of reform, because insurance companies would not be able to succeed any more just by "playing
these insurance games." They would have to start adding more value by focusing more on their
subscribers' health, and the care the subscribers get, rather than just being "the pay masters" that pay the bills, Porter said.
"But I want to be practical: I want to recognize the reality of Washington, and recognize the sheer difficulty of this particular political issue. Therefore I think the Obama administration will learn from the work so far and will be able to make the transition to tackle other problems," Porter said.