We mentioned bank robber Willie Sutton earlier this week in our initial recap of the Partnership to Fight Chronic Disease's recent policy symposium. Sutton was one of the first criminals on the FBI's Ten Most Wanted Fugitives list. We heard another infamous list during former Senate Majority Leader Tom Daschle's symposium keynote speech when he listed the major myths standing in the way of health reform. His top three:

1. We have the best health care in the world. Not always. The care you'd get at the Mayo Clinic is a far cry from what you'd find at small hospital in rural Mississippi. As we've heard Daschle say before, a better description of the U.S. system would be "islands of excellence in a sea of mediocrity."
2. Health reform would lead to rationing. Rationing already happens in the U.S., according Daschle, but it's based on person's ability to pay.
3. Any new reform would cost too much. The whole reason to pursue health reform, according to Daschle, is because we can't possibly continue to spend what we do on health care in our broken system.

Daschle's last myth especially resonates. Excuse our double negative but it's not that we can't afford health reform. It's that we can't afford not to do health reform. So how do we change our system to make high quality affordable health care a reality for all Americans? Last week's symposium featured a variety of experts, including former Speaker of the House Dick Gephardt and former Congresswoman Nancy Johnson. The discussions were insightful and we'd like present what we saw as major areas of consensus:

The current system is inefficient and unsustainable. You've probably heard this for a while from a variety of sources, but Kenneth Thorpe, the Partnership's executive director, added his own take. He emphasized that our current system has been geared toward treating acute illnesses—conditions requiring urgent or immediate care—but the majority of mortality and spending in this country can be attributed to chronic diseases.

Payment reform is crucial to changing the system. Patrick Mattingly, of the disease management firm Health Dialog (no relation to our blog), emphasized that " chronic disease management and cost control won't happen without payment reform." Nancy Nielsen, MD, president-elect of the American Medical Association noted that we pay for interventions, but not for doctors to educate and motivate their patients to manage chronic disease. She stressed the need to cover everyone, adding "a patient who doesn't have insurance won't manage their disease."

There is a great deal of common ground for bipartisan reform. As Thorpe noted, there seems to be growing agreement on the health reform agenda, particularly the need to control costs and improve quality. Further, everyone seemed to agree on the need for more health IT and evidence-based medicine. Gephardt said he was impressed with the level of bipartisanship seen in the Healthy Americans Act (S. 334), a bill sponsored by Senators Ron Wyden (D-OR), Bob Bennett (R-UT), and a list of 12 other Democrats and Republicans—a list that sure beats the one that Willie Sutton was on.