On September 6, 2022, the Gold Room at the Utah State Capitol filled with the glitterati of Utah health care delivery. Hospitals, health systems, advocacy organizations, and business leaders were there to attend the kick-off of the One Utah Health Collaborative, the nonprofit, private-sector, volunteer initiative organized by Gov. Spencer Cox because, as he put it, if Utahns don’t solve our health system woes, then they will be solved for us by federal intervention.
It was all very solemn and I’m sure well meant, but, in my opinion, not very compelling.
It’s just that I’ve been at similar meetings, with similar solemnity, many times over. I moved back to Utah in 1997 and every governor since then has had health system reform at the top of the gubernatorial agenda. Gov. Mike Leavitt ran on health system reform. He pushed for and passed HealthPrint, including 10 major pieces of legislation creating Medicaid managed care and a health policy agency.
I had several personal conversations with Gov. Jon Huntsman about health system reform, both when he was a candidate and after he took office. During his tenure as governor, the Salt Lake Chamber and other business organizations convened a high-level, blue-ribbon room full of leaders to recommend legislation.
Gov. Gary Herbert also talked seriously (or so it seemed) about health system reform.
I tried to help each of these governors with their health system initiatives. Both Leavitt and Herbert interviewed me as a finalist for the position of executive director of the State Department of Health before choosing someone else.
Despite all this gubernatorial attention over 25 years, Utahns are no better off today when it comes to finding and paying for health care than they were in 1997. Americans pay far more for health care than do the citizens of any other country and we mostly pay for it through the world’s highest health care taxes. Despite paying on average more than $12,000 for every man, woman and child, when Americans need health care, they often can’t afford it. Most Americans filing bankruptcy do so because of debt due to illness and injury costs, usually debts owed by people who had health insurance at the time they needed care.
American health care delivery is fraught with ridiculously wasteful overhead, costing $500 billion more each year than more efficient health financing in other first world health systems. American health care is least able in the developed world to prevent mortality which should be amenable to known clinical interventions. In American hospitals, patients often suffer preventable injury, leading to 240,000 premature deaths per year.
I could go on cataloguing the failings of American health care, but I am tired of listing the failures and waste of our health care system. And I am tired of listening to health care leaders and politicians talk about how we in Utah can lead the nation and solve the health care conundrum.
The health care glitterati and the governor may mean well, but the Gold Room at the Utah Capitol is not where sustainable health system reform will get done. There is only one means for really changing something as big as the health care system: the ballot box.
If you, like me, are tired of struggling to pay for or even find good health care, then educate yourself about who will be on your ballot this November. Incumbents have already had a chance to reform the health care system and have failed. I suggest you ignore party affiliation when you vote and simply vote for new leadership. If you want change, then change who represents you in Congress and in the Legislature.
Joseph Jarvis
Joseph Q. Jarvis, M.D., is a public health physician and the author of two books about American health system reform: “The Purple World: Healing the Harm in American Health Care” and “For the Hurt of My People: Original Conservatism and Better, Simpler Health Care.”
