Most everyone has spoken out on health care reform. Obama has now set a (televised) meeting with Republicans on February 25 to see if bipartisan support can be achieved to pass health care reform this year. So ,what ideas can be so new and different to come from any meeting that have not already been considered and trampled soundly into the ground/

For one, there has yet to be a declared consensus about how this area of our existence should be considered. When Obama meets with his colleagues, this should be the first topic on the agenda.

Is health care simply a product to be bought and sold; is it a right, like so many other industrialized countries view it; is it a privilege attainable for only those who can afford it; or is it a responsibility of the government to ensure, like providing heat or electrical power for one’s home? Obama was asked what health care was when he debated McCain in Nashville back in the Fall 2008. He said it should be a right, and not a privilege or responsibility. Teddy Kennedy said it was a right at the Democratic convention; so have many others, including this writer.

I don’t say that health care is a right in a constitutional sense, for it is not specifically identified in the Constitution. We do know that the Bill of Rights declares we are, “endowed with unalienable rights, among them are Life, Liberty and the pursuit of Happiness”, but issues of accessibility and affordability to health care were not forefront on the minds of our Founding Fathers—health care was generally available to all citizens back then, and was not an integral part of the 1700s as it is in today’s society—so it is doubtful that the Bill of Rights intended to include health care with its words. We also know that the Supreme Court has interpreted the 8th Amendment’s “cruel and unusual punishment” clause to require prisoners be guaranteed the right to health care. Even the United Nations’ Universal Declaration of Human Rights adopted in 1948 declares, “everyone has the right to a standard of living adequate for the health and well-being of oneself and one’s family, including food, clothing, housing, and medical care."

Health care affects every single American, perhaps like no other area of human existence. Everyone knows what it is to be healthy and to be sick or infirm. Stated differently, but for being healthy, we cannot be productive to ourselves, our families, our employers, our communities, indeed in the end, to the nation’s economy. It would be a major step, therefore, for the President to start any meeting with Congressional leaders later this month to view the ability of being free from sickness or disease, i.e., being healthy, as a right. The trick is, how to achieve this goal.

Another prerequisite to any successful get-together is to leave all lobbyists and special interests at the door. Health care reform cannot be based on what it will take those at the table to get re-elected either this November or in 2012. The interests of the few should in no manner impede the benefits for the many.

Next on any agenda should be issues on which there is broad agreement. This is all laid out in a very recent piece that I co-authored with (now retired) insurance executive, Andrew Kurz. It can be found at, http://haloftheeighth.blogspot.com/2010/02/health-care-reform-separating-wheat.html. The focus is on access, affordability and quality.

Because the route to access is typically through an insurance policy, coverage should (a) not exclude pre-existing conditions; (b) not allow cancellation of an existing policy owing to a medical condition; (c) guarantee issuance and renewals; (d) extend dependent coverage to a certain age; and (e) allow cancellation only on non-payment of premium or fraud in the procurement of a policy.

With respect to affordability, broad agreement exists on policies (a) not setting a lifetime or annual limits on benefits; (b) setting reasonable limits on cost-sharing—deductibles and co-pays; (c) not allowing price differentials based on sex; and (d) setting reasonable restraints on age-related differentials.

Within quality, there is little disagreement that coverage should (a) not require cost-sharing for basic care; (b) require an essential, uniform package of basic services; (c) standardize forms to reduce paperwork and increase efficiency; and (d) computerize medical records without running afoul of privacy laws.

The issues on which broad disagreement remains should take up most of any bipartisan meeting. These include how to keep insurance costs in line: the public option certainly does this; so would lifting the anti-trust exemption; and purchasing insurance across state lines would help achieve this goal too. Other of these issues are affordability credits for those less able to obtain coverage, a mandate that all Americans be covered, tort reform, discounting drug prices under Medicare, and interim protections while reforms are being implemented, like establishing a governor on premium costs and who will pay for reforms like no pre-existing condition will bar coverage.

In the end, it is not what it takes to get re-elected that matters any longer, only how to fix a broken-down system where disaster lurks around the next corner.