The only debate that emerged from “Healthcare: the Great Debate” was whether a debate had actually occurred.
The proposed event, which served as the keynote to the annual meeting of the Jewish Association on Aging, presented a panel of diverse medical professionals, including Andrew W. Gurman, past president of the American Medical Association; Martin Gaynor, E.J. Barone Professor of Economics and Health Policy at Carnegie Mellon University; Daphna Gans of the David Geffen School of Medicine UCLA and the UCLA Center for Health Policy Research; and Karen Wolk Feinstein, president and CEO of the Jewish Healthcare Foundation.
With Feinstein serving as moderator and probing participants with assorted inquiries, the conversation illuminated a murky subject.
“There’s a lot of confusion about healthcare today,” said Mitchell Pakler, JAA board chair. “There is misunderstanding. People just don’t understand healthcare or where we are going, and with the current political environment, the consumer is the one who gets lost.”
“This is a topic we all care a lot about,” noted Feinstein.
That assertion was overwhelmingly agreed upon by the invited speakers, who told the more than 100 attendees at Levy Hall in Rodef Shalom that universal healthcare is a “moral obligation,” that the Affordable Care Act should be “fixed” and not revoked and that people are mostly to blame for the system’s shortcomings.
As opposed to healthcare being a “privilege or a right,” it is actually “a mitzvah,” said Gaynor, who like Gurman, delighted listeners with sprinklings of Hebrew and Yiddish terms throughout the remarks.
“The system has a lot of problems that need to be addressed, but we first have to agree that it’s a moral obligation that everyone is covered,” said Gans.
“We need to build on the successes of the Affordable Care Act and fix what’s wrong with it,” added Gurman.
The ACA “brought insurance to 20 million people,” said Gaynor. “At this point, what is necessary is to reinvest in programs and encourage younger people to get into the pool,” adding that “if only sick people get insurance, then the market collapses.”
Shared responsibilities are intrinsic to universal healthcare, but what steps are needed to bring Americans on board with this mindset, asked Feinstein.
“Culture has much to do with the situation”, said Gurman. “We can’t just superimpose the demands of a single-payer system on the masses, there is always an out. Whether in Israel from the Kupat Cholim or in England from the National Health Service, there is an escape valve. In Canada, the escape valve is the United States.”
As much as people may be beating the drum on universal healthcare or a single-payer system, there are harsh realities to be faced, explained the panel.
“We’re not talking about waiting an hour and a half in your doctor’s office reading Field and Stream from 1980 but weeks or months to get care,” said Gaynor.
“Patients can end up waiting eight to 12 months for a 15-minute surgery,” added Gurman.
Certainly technology could ease burdens, noted the speakers. But, asked Feinstein, what role will it play moving forward?
“Technology will develop and aid problems with geography,” said Gans, who described a disparity in health due to patients’ locales. For those people based in remote areas, “technology could create a collaboration,” she explained.
One need only look back to the transition from steam to electric power to appreciate what lies ahead, said Gaynor. “It is not just having technology at hand, but learning how to use it. We don’t figure things out overnight. Everyone has to be pushed to do certain things. We’ve got the technology; we need the human organizations to catch up.”
The impediment, though, is money, explained the economist.
“Anything in healthcare that is one person’s cost is another person’s income, and that makes it difficult to change,” said Gaynor.
“In the immediate, we need to address the ACA. As for the longer term, we need to address healthcare costs,” added Gurman.
During the question-and-answer session much of the same sentiment from the mostly harmonious discourse was expressed.
“Getting everyone healthcare will be hard; bringing down the costs of healthcare will be harder,” said Gaynor.
The takeaway from the discussion is that there is “no easy solution for universal healthcare coverage. It is certainly at the [forefront] of everyone’s minds,” said Deborah Winn-Horvitz, JAA president and CEO who, like others, praised the panel following the well-regarded event.
“This was an outstanding program. It was informative, educational, had a sense of humor entwined in it and it touched upon a lot of different issues in healthcare,” said Sara Guttman of Squirrel Hill, who added that apart from raising a lot of questions, “it made you want to do a little more research on your own.” PJC
Adam Reinherz can be reached at