Whither health reform?

As I have said many times over the past couple of years — in blog postings, speeches and interviews — I am VERY much in favor of health reform. The inadequacies and inequities of the American health care system are obvious.

In the half-year since we had national legislation passed and signed we have seen lots more pulling and tugging on this issue.

I continue to say I support substantial overhaul of the American system of health care delivery and financing. The legislation that was passed is not perfect — but I wish my friends Don Berwick, Nancy-Ann DeParle and many others every success in getting the new framework in place.

But a lot is up for grabs — and the upcoming national and state elections on November 2nd have the potential to impact this all greatly.

Some are pushing for repeal of the new law. I think that is highly unlikely to be the next step, but we are sure to have lots of debate.

I have said all along that what was passed is not perfect — and it is not exactly what I would have done where I the czar in charge.

We really do need to be much more focused on the cost of health care — and not just in the distant out years. It is very likely that the new leadership of the Congress will push us all to be much more engaged on the issues of the federal budget deficit and debt, and that will directly lead to a glaring focus on Medicare, Medicaid and health care costs in general.

As has been said — with some humor — predictions are always difficult, especially about the future. And I surely cannot predict with accuracy where all of this will end up.

But I surely know that we need to speed up our efforts right here at UNC Health Care to design and implement more cost effective ways of delivering care that will allow us to continue to meet our missions successfully.

Our various constituents expect no less of us — and (not to be too dramatic) our survival depends on it.

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