Better a caring government that acts, or one that errs through indifference?

In the second of his 2-part series on SAS’ recent Health and Life Sciences Executive Conference, Barry Gay discusses the keynote delivered by Philip Johnston.  Johnston’s perspective as a leader in the Massachusetts health insurance industry provided a stark contrast to Mike Huckabee’s view of the current health reform efforts.

If history looks kindly on the health-care reform bill signed into law a few weeks ago after nearly a century of on-again, off-again debate, posterity will surely mark it as a defining achievement for President Obama.

After all it was President Obama who had – to borrow a word he popularized during his warp-speed political ascent – the “audacity” to resurrect a fight that many presumed dead after it went down in flames in the early Clinton years.

Not even the mighty – nor the mighty persuasive – FDR could win that battle. He could save the world from the vilest personification of evil. But he dared not risk losing support for what became the Social Security Act of 1935 by including a health-insurance provision.

No matter what the “Monday-morning” historians of tomorrow will say about today’s venture into federal control of health insurance, Obama will get all the credit – be it good or bad. Still, as the president basks in the afterglow of his biggest achievement so far in his brief tenure, he has Philip W. Johnston to thank.

Johnston, a leader among giants in the Massachusetts’ Democratic Party and chairman of the Blue Cross and Blue Shield of Massachusetts Foundation, was a chief crusader and architect of the commonwealth’s own health-care reform plan, which served as a model for the new national plan.

He spoke at the recent SAS Health and Life Sciences Executive Conference. His remarks in favor of the new legislation followed those from former GOP presidential contender Mike Huckabeee, who opposed the reform package.

Despite their differences, they both advocate a system that rewards quality outcomes through doctor-patient relationships focused on prevention through intervention and individual responsibility. With analytics, insurers and doctors can easily predict patient outcomes based on behaviors, demographics, circumstances, you name it. They can see how two seemingly unrelated events in a patient’s medical file are harbingers of morbidity.

Shifting the medical community from assembly-line care to preventive care will save untold billions of dollars in insurance payouts and hospital losses while helping patients maintain a decent quality of life. Loss of health equals loss of income. In the broader equation, loss of health equals loss of productivity; and loss of income equals loss of spending power.

To Johnston, the warning signs are in place: US childhood-obesity rates are fueling an epidemic of adult-onset diabetes among juveniles. To prevent further declines in the nation’s physical and financial health, government has a moral obligation to play doctor.

To that end, Johnston summoned the words of FDR himself, spoken in Boston in 1936 as both his political detractors and the Supreme Court picked apart his New Deal idealism: “Better the occasional errors of a caring government than the intentional omission of a government frozen in the ice of its own indifference.”


  1. National Guard Health Affairs
    Posted May 8, 2010 at 7:30 am | Permalink

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  2. Reed Pettingill
    Posted May 8, 2010 at 11:23 am | Permalink

    I also believe in preventative care. There is no magic formula for preventative care, but I think we can all take common sense steps to take care of our bodies. First look at you family lines. What diseases or illness are common in your family lines? Learn all you can about your family health issues. Then start to change your diet, lifestyle or whatever other changes are required to try to prevent it from happening to you. For example digestive tract cancers runs in my family. So I am trying to eliminate the pollutants and chemicals I ingest. I researched about chemicals in my tap water and got a water distiller to remove all of the chemicals. This is one thing I have changed. Good luck and take preventative control of your life today.

  3. Barb Benson
    Posted May 10, 2010 at 4:29 pm | Permalink

    I believe the old adage "an ounce of prevention is worth a pound of cure". It is important that we all focus on prevention when it comes to our health and the health care system. I think the govt. can save millions of dollars on an annual basis through preventative measures and testing. We will all benefit if we channel our efforts in this direction.

  4. Osteoarthritis
    Posted May 12, 2010 at 7:48 am | Permalink

    I certainly agree with the other comments that we all have to take a personal responsibilty for our own health. We should not be relying on others to do it for us.
    However, this does mean that a certain amount of education is required, particularly of the young who are the ones who are really going to suffer from the current trends of obesity and early onset diabetes.
    So the schools and the education system have a major role to play here.

  5. Adam
    Posted May 14, 2010 at 1:02 pm | Permalink

    I think the health problem of the rising childhood obesity isn't one that government can ever solve - it's a cultural issue. We have it easy here. Food is cheap and plentiful. Kids don't work - they're raised by TV. That adds up to chubby children.
    No amount of legislation is ever going to fix that. I mean, we've been fighting the "War on drugs" for over 40 years - and drugs are more plentiful and cheaper than ever. It's been a dismal failure.
    What deludes politicians into thinking the "War on Fat" is going to be more successful?
    The title of this post makes it sound like there are only two things the government can do: act to help, or err by doing nothing. Well, what if the government's actions do not help, but merely become a greater financial burden on the people? What if the action the government takes is harmful?
    I think it's at least worth discussing.

  6. Jason Burke
    Posted May 14, 2010 at 1:59 pm | Permalink

    For clarity, the title of this post reflects the liberal viewpoint advocated by Johnston. For the counterbalancing conservative view, see the prior post related to Huckabee.

  7. encinitas chiropractor
    Posted May 15, 2010 at 2:53 pm | Permalink

    I can tell you that government run health care is a bust. Our current government run health care (Medicare) is a disaster. It is bad for the patients and the doctors. And Medicare is only peanuts in size to what they want to do. Medicare is now an overburden and bankrupt system, and if they cannot make a small system work, they sure are not going to be able to make a larger system work as well. We are in trouble.

  8. Christine Maale
    Posted May 17, 2010 at 6:42 pm | Permalink

    Preventative medicine is great... I think we would all agree on that. And the government providing programs to educate and promote health and preventative care and actions is great, especially for children. But theres a big difference between that and government run healthcare.
    The government has a moral obligation to play doctor... that is rediculous. The government has an obligation to withhold the constitution so that we can live in a free democratic country. That includes making our own choices and deciding for ourselves what is best for us! The doctors are the doctors... and they should be the ones to decides who needs what care!

  9. Erica Smith
    Posted June 18, 2010 at 8:32 pm | Permalink

    Maybe we have reached the point where no one believes that any politician, even the biggest we have, could actually do something for the right reasons. And that is not just ugly. It is obscene.
    You don't have to like this bill, you don't have to like Nancy Pelosi, you are allowed to think that Barack Obama should have spent more time over the past 14 months talking about the people who are out of work in America rather than focusing on the ones without health care in America.

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