The No. 1 question: will all have access to quality, affordable health care?

by Jeffrey Korsmo

So far, the health care reform debate has produced many headlines with the patient perspective often drowned out by partisan positioning and pundit analysis. Now it's time for all Americans to tune in and raise questions about how our representatives' actions will affect them. Health care reform isn't just about policy and politics; it's about us and our families.

Congress is in the midst of a historic debate, the results of which could cover more than 46 million Americans without health insurance and finally could solve problems that have stumped policymakers for half a century.

But in the end, successful health care reform should address one concern: Will every American have access to high quality, affordable health care?

Unfortunately, under the current health care system the answer is “No.” Over the past few decades, U.S. health care has focused on providing more care, even if it doesn't improve our health. We are learning that more office visits, more tests and more procedures often do not produce better health care. It's just more expensive care - much more expensive.

Consider Medicare, the government program for elderly Americans. Annually, Medicare pays more than $8,300 per patient on average and up to more than $16,000 per patient in some regions of the country. But according to Dartmouth Institute researchers, some states with the highest spending provide some of the worst patient care quality.

Symptoms of this type of care are fairly common: You may notice your health care is not focused on what's best or most convenient for you. You may feel your doctors and specialists don't work together or communicate with each other, so it is your responsibility to re-explain your condition and ask questions multiple times to get answers. And if you are lucky enough to have health insurance, you've likely experienced soaring premiums, co-pays and other out-of-pocket costs.

In Rochester, Minn., and much of Iowa, the focus is much different. Communities are striving to provide patient-centered care, a team approach that improves communication and efficiency, and a commitment to innovate and use technology that better coordinates care and reduces unnecessary costs. The result also is different: high-quality care at costs much lower than the national average. Unfortunately, the current system does not reward this, so it is becoming more difficult to provide it.

These qualities have made Mayo Clinic and other providers leaders in health care. But all health care providers could adopt these principles if members of Congress focus on quality and affordability.

This month, U.S. Sen. Chuck Grassley, R-Iowa, and his congressional colleagues are home for summer break to reconnect with you, their constituents. Take this opportunity to ask them the following questions:

1) If health care is too expensive, why does the current system pay for ordering unnecessary appointments, tests and procedures that push costs even higher? Shouldn't the system instead encourage doctors to work as teams to provide high quality care at a more affordable price?

2) Why can I lose my insurance if I've lost my job or have a pre-existing condition, even if I'm managing the condition well and doing everything I can to stay healthy?

3) If Medicare isn't sustainable now, doesn't expanding a Medicare-like system make the problem bigger and push costs onto our children and grandchildren?

Health reform won't be easy, but it is absolutely necessary. Congress and President Barack Obama should not settle until they can answer “yes” to every American's need for high-quality, affordable health care.

Jeffrey Korsmo is executive director, Mayo Clinic Health Policy Center, Rochester, Minn. More information at www.mayoclinic.org/healthpolicycenter/