Years of promising to repeal and replace the Affordable Care Act took a major step last week with the House passing the American Health Care Act. The years of rancorous debate leading to this vote have highlighted the profound divisions in our political system. But, it has also obscured the encouraging reality that most Democrats and Republicans actually share a common goal – the creation of a high quality, high-performance, high-value health care system. We cannot continue to spend more than $3 trillion a year on health care, yet lag behind much of the developed world in overall health outcomes.
Fortunately, one lesson has held true throughout our decades in government and politics representing both sides of the aisle: Sustainable and effective health policy can only be achieved through collaboration with all stakeholders — providers, payers, patients, policymakers, researchers and thought leaders alike.
That’s why the National Academy of Medicine, one of our country’s most trusted source for evidence-based policy guidance, drew on the insights of 150 prominent health-policy experts to develop Vital Directions for Health & Health Care. For 18 months, as members of the initiative’s bipartisan steering committee, we carefully examined how to address pressing national challenges — high health care costs, disparities in health, and the burden of chronic illness and disability — and we collectively proposed the most promising options for the future.
Vital Directions offers a practical framework of achievable priorities that will advance health, health care and scientific progress. The ideas presented not only directly address the issues of cost and improved outcomes, but they build on interests around which there is considerable bipartisan support.
Drawing both from a broad evidence base and from lessons learned from past efforts at health care reform, the Vital Directions model, published in the Journal of the American Medical Association, outlines the foundation of what we believe would be an optimal health care system that would improve the prevention and treatment of costly, chronic diseases from cancer to cardiovascular disease to diabetes and obesity.
The framework underscores some basic tenets. A newly redesigned system must deliver high-quality, affordable care and must empower patients and families to become active consumers and partners in their own care. The health system needs to provide easier access to all the information and communication channels necessary to help patients and their families make more informed health care decisions. We must also activate entire communities to redouble local efforts to eliminate health disparities through public-private partnerships that improve the social determinants of health, such as education, housing, employment, social supports and clean, safe environments.
These objectives can be accomplished by leveraging America’s strengths in technology, research, data-gathering and analysis. We must adopt consistent, meaningful measures to assess quality without overburdening health care professionals and interfering with their ability to deliver high-quality care. Real-world, real-time data and powerful analytic health information technology will greatly aid practitioners, while simultaneously making such data quickly accessible to patients across various platforms. Better, more accountable use of technology will lead to more rapid development of valuable new therapies. But — all of this depends on accelerating investment and improving efficiency in the advancement of scientific research and innovation.
Additionally, we need to address health care workforce shortages and bolster the training and practice patterns of the American workforce. Skilled, caring health care professionals working as integrated teams are vital to delivering higher-value care and better population health, while dealing with a more medically complex population. Such modernization will require engaging leaders in government, health care, and higher education to collaborate to attract, train, and retain a diverse workforce to meet the needs of the future.
Over the last 20 years, we have seen powerful bipartisan and multi-stakeholder collaboration in health policy — the creation and reauthorizations of the Children’s Health Insurance Program (CHIP), the growth and expansion of community health centers, and the enactment of legislation, such as the 21st Century Cures Act. As our country’s leaders consider the future of our health care system after the House’s vote, we encourage the administration and congressional leaders from both sides of the aisle to come together and forge a sustainable path forward as these critical discussions continue.
Tom Daschle, a Democrat from South Dakota, is the former Senate majority leader who served in Congress from 1979 to 2005. Michael Leavitt, a Republican from Utah, served as governor from 1993 to 2003, and as secretary of the Department of Health and Human Services from 2005 to 2009. They are members of the National Academy of Medicine’s Vital Directions for Health & Health Care Initiative steering committee.
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