Managed Care - May 2008 - (Page 40) cause there are too many interconnected variit’s simply a problem that must be resolved. ables. But inevitably the pressures on publicly MC: How close can we get to universal coverage? funded insurance for seniors are going to be sigTUCKSON: I don’t know the answer to that. I am on nificant. That will lead to a real opportunity for the ground doing this in real time, and my goal health plans to be able to continue to demonis to cover as many people as we can, as quickly strate the cost-effectiveness and enhanced clinias possible. We just have to keep pushing for that cal outcomes that are associated with innovation. with urgency. Can we cover 100 percent of the We have the ability to demonstrate—particupopulation? That should be our goal, yes. And larly for people who are poor, people of color, while we are trying to reach that 100 percent and for people who are living in challenging engoal, we have to keep implementing programs vironments—that the benefit that comes from that will cover people today. My frustration is the private sector in operating these programs is that each night that we continue to debate pertangible, substantial, and meaningful. I’m optifect solutions, people die. So when preventable mistic that the American respect and enthusiasm death is a consequence of failure, I have very litfor innovation and for the benefits of a compettle patience for the unwillingness to move foritive environment will continue to be available as ward. I am passionate about this. We need to we try to solve very difficult and increasingly take as many concrete steps as possible while we important social problems. continue to work on the ultimate solution. MC: You are a leader in the call for universal coverMC: What is the most important thing insurers can age. Does universal coverage imply a single-payer do? system? TUCKSON: First and foremost, insurers need to continue to do the work that we have chosen to TUCKSON: If we are able to realize health care coverage for all Americans, the soludo, which is to organize health care tion is almost certainly not going The genetic revolution assets as cost effectively as possible to be single payer. Those of us who is upon us, full force. while also supporting the delivery are passionate about making sure of quality care. We have to keep And the clinical, all Americans are covered are condoing our fundamental blocking scientific, and ethical cerned about finding a political and tackling very, very well so that equation that will enable us to get decisions that accomhealth care costs do not continue the necessary political support and pany that revolution to escalate and become unaffordvotes to get to that reality. A single- present a daunting able to the average American, payer system would not win that challenge for most thereby driving up the rate of the support. uninsured. That seems like a given, Americans. but we have to recognize that what MC: What solution do you see emerging? we do as an industry is so vital in this regard that we should not take that work for granted. TUCKSON: The challenge for every well-meaning stakeholder with a determinate voice in this deMC: Are there other concrete actions insurers can bate will be to give up our first choice and find take right now? some common ground. We are going to need to TUCKSON: We have to participate responsibly and be enormously flexible and willing to consider aggressively in coalitions that are seeking to move positions that we might not originally be comthe public discourse and the legislative agenda fortable with. The debate will have to have broad forward. As just one example, UnitedHealth is participation, and we will have to look at a broad participating in the Health Coverage Coalition variety of tools and strategies; it will require the for the Uninsured. We hope to define that specompanies in our industry to play a major and cial calculus of political support and legislative continuing role. I would urge everyone in our invotes to get laws passed that will cover as many dustry to continue to be very vigorous propopeople as quickly as possible. But if we are going nents of getting all Americans access to health to participate in coalitions, we have to be precare as quickly as possible. At the end of the day, pared to be flexible. Nothing will happen if every- 40 MANAGED CARE / MAY 2008
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