by Gregory L. Pemberton, Ice Miller, Indianapolis, IN
A recent headline from our local newspaper read "A Cure For What Ails Health Care." The opinion editorial articles that followed tried to answer that challenging question. It started me thinking about the practice of law and the healthcare industry. Those are two subjects about which I have a bit of history in that my legal career has followed the collision of the two.
When I started my law practice almost twenty-five years ago, there were lawyers who represented doctors and hospitals in business matters, litigators who sued or defended doctors and hospitals, and labor and bond lawyers who represented healthcare concerns. Very few lawyers would have described themselves as healthcare attorneys. Had we met at a party and you were kind enough to ask what I did, I would have rambled on about cost-based reimbursement, certificates of need, and hospital restructurings. Your eyes would have glazed over after about twenty seconds and that would have ended our conversation.
All that changed in the early nineties. Then President Bill Clinton and now Senator Hillary Clinton certainly pushed healthcare to the front burner of public debate. Suddenly, what I did was interesting. I remember giving speeches about the Clinton Plan and how it would alter the system of healthcare delivery and financing in this country. The public discourse was loud and quite broad. The Plan per se did not make it. (Although discrete pieces like HIPAA did as part of portability legislation) But the buzz about healthcare had become popular and the stuff of news magazines and talk radio.
That brings me back to the articles in my paper. The CEOs of a pharmaceutical firm, a health insurer, and a hospital system were all contributing authors. Two physician leaders rounded out the group. Their collective advice on "the Cure" included a number of familiar themes. We need to do a better job of managing the care of the chronically ill, let the consumer drive healthcare delivery and payment, eliminate wide-spread disparities in care based on racial and ethnic factors, use technology better, fix malpractice laws, insure universal coverage, and even stop wasting time fighting about specialty hospitals. All of this is pretty sound advice. The only question that remains is who will collectively lead this effort. The debate rages on about the pieces of the system. I suspect it will take a crisis to motivate the political and business interests in this country to truly lead to change. For now, the misaligned incentives of our current system remain.
Which leads me back to practicing healthcare law. If you are reading this article, you are already self acknowledging your involvement. Can you help the business and political leaders of your community in at least understanding why it costs so much and what steps may be needed to effectively reach "the Cure"? I suspect that you can. As healthcare lawyers, we need to step up and be proud of the role we can play in this important issue of our time. Is this a call to action? You bet.
One more word on a totally unrelated topic. My hometown Indianapolis Colts are on quite a roll. It is especially gratifying because they are led by a humble and yet brilliant coach. Their quarterback is the real deal, their running back is a shoe-in for the Hall, and their receivers are amazing. The defense has been amazing as well. I am hoping that when many of us gather in Tucson in February of 2006 for the Emerging Issues program, my guys will have bestowed bragging rights on this fan in blue. Take care.