SHAPE THE FUTURE

SHAPE THE FUTURE---In a stirring and forceful speech, President Obama delivered a bipartisan centrist message that appealed to our character as a nation. Noting that we cannot fix the economy without fixing health care and promising not to increase the deficit he inherited, the President called for mandated insurance coverage for all Americans. Recognizing that the status quo is untenable, he called for the creation of an insurance exchange and for the so called "public option" to be created whereby those without insurance currently, could get coverage ----noting that it might take up to four years to implement. He also explicitly linked our need to reduce waste, improve quality, reduce hospital acquired infections and practice better team based care to the set of tools needed as part of the solution. From a policy perspective the speech clarified his own views and reinforced the notion that we have to build on the existing system. He did not disconnect insurance from the place of employment, he did not call for a major Medicare overhaul and he did not create major new federal bureaucracies to make his plan operational. Much more work needs to be done but I believe he effectively re--set the clock, re--set the arguments, and crafted a political umbrella under which lawmakers can now operate together. DAVID NASH MD MBA, Dean, Jefferson School of Population Health, Phila, PA