Dead man says: Reform healthcare

This column is being written by a dead man — more precisely, a formerly dead man. On Labor Day weekend in 1989 I was stopped dead, literally, by a cardiac arrest in the wee hours of the morning. Fortunately it happened in Seattle, home of the best emergency response teams in the world, and my heart was restarted through the heroic efforts of fast-acting Emergency Medical Technicians. When I awoke two days later in Harbor View Hospital I was told that I had a rare congenital condition that had triggered an electrical short-circuit, causing my heart to stop beating. There was no cure — but there was a new medical procedure the doctors believed could protect me from a recurrence. It required splitting my chest open, attaching electrical leads to my heart and implanting a device to monitor my heart rate and deliver an electrical shock should the ticker ever stop ticking again. It is an on-board defibrillator that does not require someone to dial 911 to bring me back to life. The device has since fired five times, and I am eternally grateful for it no matter the delays it causes in clearing airport security.

A recent Newsweek cover carried the headline “This man was dead. He isn’t anymore.” On the inside pages I was reminded that 95 percent of those who suffer a cardiac arrest never live to write about it. I was one of the lucky ones. Modern medical technology brought me back to life and has given me nearly two decades I would have never seen save for good luck, fast-acting paramedics and high-tech medicine.

A recent poll conducted by Greenberg Quinlan Rosner for Democracy Corps points out how important such stories are to understanding a healthcare policy debate that is beginning to loom large on the political horizon. According to Greenberg, two-thirds of Americans support “profound changes” in the American healthcare system. They are concerned about its costs, worried they may lose coverage and frustrated with the bureaucracy of insurers. “The desire for reform is real and matches 1993 in its intensity,” according to the Democracy Corps report. Much else in this study harkens back to the great healthcare debate of 15 years ago, when two-thirds of Americans said they wanted “radical reform” of the healthcare system. Then, as now, reform means one thing to policy wonks and something else entirely to voters. It all depends on what questions you ask and how you ask them.

In one revealing set of questions, the pollsters asked if voters preferred a “Canadian-style national healthcare system” or “incremental steps” to improve the existing system. “Canadian-style” won by a 10-point margin. When the same question was asked with the phrase “funded and administered by the U.S. government” added, the “Canadian-style” option lost by three points. Americans are no more ready for “government-run healthcare” today than they were 15 years ago. They don’t want to trade an insurance bureaucracy for a government bureaucracy. That concept sank Clinton Health Care in 1993-94 and it will doom any reform plan proposed today that features a single-payer, government-administered healthcare system.
While healthcare policy experts may not think the existing employer-based system is a good one, the American people are comfortable with it. They want the existing system reformed, not replaced by a new government bureaucracy.

Voters want healthcare reform, but they also want to protect what they now have. The Democracy Corps research shows Americans are overwhelmingly satisfied with the quality of healthcare they personally receive. Other studies have shown Americans believe in high-tech healthcare, want to see more medical advances and think the most cutting-edge medicine in the world is practiced here. When Americans talk about reform, they mean healthcare coverage they can afford and they can keep if they get sick or change or lose their job. Most are willing to pay higher taxes to make sure everyone is covered.
But they don’t want to risk losing the kind of cutting-edge medicine that saved my life, and they certainly don’t want that care rationed or managed by government bureaucrats.

We do need to reform America’s healthcare system. That issue will play a major role in political debates between now and November 2008. The clear message from voters is that reform proposals must guarantee choice and quality care or they will ultimately be rejected. That hasn’t changed in 15 years, and it won’t change in the next 15 months.

Goddard is a founding partner of political consultants Goddard Claussen Strategic Advocacy. E-mail: