The U.S. Healthcare Constitution website is still under development.  This blog will be used for updates to The Project status.  We expect that the website will go "live" by October 5, 2009.

The U.S. Healthcare Constitution Project is an effort to reach a national consensus with respect to the type of healthcare system we wish to have in the United States, as well as defining the rights, responsibilities, powers and limitations of the primary participants in the U.S. healthcare system. These participants include patients and their families, healthcare providers, government, healthcare insurers and those who pay for the care provided.

We believe that the need for this project and a healthcare constitution is self-evident.  In no other single part of our society and economy are the personal stakes so high, the costs so massive, and the potential for harm and good being done on a mass scale so prominent, as in healthcare.  Despite this, neither our business nor political leaders have attempted to articulate a broad and complete version of how our nation should approach the nature, financing and delivery of healthcare goods and services.  This has left even the most basic questions unanswered as a matter of public policy.  Some examples include:

• What is the basis on which our nation should choose to adopt (or neglect to adopt) universal health insurance coverage?
• Since there can never be enough resources to provide every desired healthcare good or service to every American, how will decisions regarding the inevitable allocation (also known as "rationing") of these goods and services be made?
• Powerful organizations like health insurance companies and government agencies have the ability to make decisions that profoundly affect the economics of healthcare, as well as the rights of patients and providers.  If unchecked, they have the power to interfere in the decisions that patients and providers might expect to make privately.  What limitations should be placed upon these organizations to ensure that their power is not abused?

In the absence of a general consensus on the type of healthcare system Americans wish to have (and a written document that describes the nature of that health system), there is no meaningful healthcare "debate".  Why?  To illustrate, let's take an example from a different field.

Let's say that everyone agrees that we need "transportation", but no one bothers to agree upon how many people we intend to move, how fast, where they'll need to go, along what route, or what the budgetary limitations might be.  Various interest groups immediately begin to plug their own agendas.  Environmental advocates insist that the whatever fuel is used must be renewable and environmentally clean.  NASCAR members want the vehicle to have a huge powerplant capable of high acceleration.  The auto companies want the product used to be built here, while each politician wants the effort led from their state.  Hosts of other interests weigh in with their own requirements, ranging from safety groups to anarchists. Many of these requirements conflict, but since the overall goals and conditions have not been formally agreed upon, there is no way to determine their relative value or limitations.  What gets built?  Probably nothing.

Healthcare in America today is facing a similar situation.  Everyone agrees that what we have now isn't sustainable, but no one has bothered to develop a consensus with respect to what the ultimate mutually achievable goals of our healthcare system should be.  This is why we see lots of arguing with little or no progress.  The only way to weigh one proposal against another is if we all understand what the end result is supposed to be, along with the rights, responsibilities and limitations on the various participants are along the way.  If those rights, responsibilities and limitations clearly conflict, you're not going to have an functional or sustainable system.  Delineating the framework for a functional, effective, just and sustainable healthcare system is what the U.S. Healthcare Constitution process is all about.

We invite you to learn more about this project and to join us in crafting and implementing a document that sets realistic and generally accepted healthcare expectations for our nation.

After all, if we don't decide what we want in a healthcare system, someone else will decide for us.