Health Insurance Reform---NOT REAL REFORM

I am struck that most of the national conversation about "health reform" has really been all about "insurance reform". Missing from the national conversation are the crucial issues that face our dysfunctional system----unexplained clinical variation, waste, the epidemic of medical errors, solving the tort crisis and much more. NONE of the proposals coming from the Senate or the House even begins to get at these critical issues. We need leaders in Washgington and elsewhere to confront what is really broken and begin the difficult process of self evaluation to fix these core issues. We spend the most and get the least. Sure, on a particular case by case basis we might be fortunate enough to have insurance and to get great medical care---this is not the issue. The issue remains as to how to create value, how to reorganize the system to promote coordination of care, how to realign the financial incentives and finally, how to make the whole thing patient centered. I don't know about you, but my patience is almost running out. I hope we can get the conversation back on track to address these issues that truly matter, and that can help us deliver real reform. DAVID NASH