A Crisis in Trust: Health Care Credibility

I feel the need to touch on an underlying issue that I think we all should be concerned about from the public policy perspective. This issue is credibility. The concern is that we allare at risk of losing credibility—in many instances through no fault of our own.  With that loss is the placing at risk many of the advances in health care and health outcomes that those in the health care industry, state government and consumer advocates have worked so hard to achieve.

The credibility issue stems from the ongoing adversarial and political rhetoric on both sides regarding national health care reform and that continues to permeate all health policy discussion at the state and federal level. Our polling over the past years shows about a 50/50 split in consumer attitudes regarding reform. Many consumers are either totally for reform or totally against, perhaps preferring the status quo, while other consumers prefer some aspect of reform—but not others.  These voices are heard by our political leaders and without a clear message. Choices are often then determined more by the political advantage. Our members have been in the middle of this policy debate and been accountable for delivering services under reform in the Medicaid expansion arena and in our public insurance exchange–but have felt the advocacy from both sides.

We should all agree that regardless of our opinion—the fact that there are strong feelings on both sides of federal reform has contributed to confusion and misinformation on behalf of the public.   To add to this confusion and strain on credibility, was the actions of several lawmakers that ultimately consumed time, energy and much public ridicule before finally concluding with expulsion, resignation, special primary election and finally national television coverage. Did we need to see our wounds on this issues exposed one more time on ABC’s 20/20?  This was taking place as the debate on road funding was being determined—first by referendum and then by legislative action.  At this stage, clearly the credibility of state government and the legislature was at an all-time low.

The final stake on credibility is of course the Flint water crisis.   Others will comment on the origin and results and need to “make it right”.  That is not my point in this message.  Make no mistake, one of the outcomes of this crisis goes far beyond Flint and is the loss of faith (trust) toward government and any governmental administered programs.  Once lost, this trust is most difficult to restore.  So where do we go?

We’ll pick up where we left off next week with the next blog post.