If ever there were a time for high-level intervention in the debate over reforming the American health care system, former U.S. Sen. George Mitchell of Maine says, this is it.

Things have grown substantially worse since 1994, when, as Senate majority leader during the Clinton administration, he undertook an ill-fated effort to bring about serious change in the health care system, Mitchell said in a telephone interview Tuesday.

“We’ve had 14 more years of experience. More people are more aware of the problem, and there is a growing consensus that something must be done,” he said.

One of four high-profile former majority leaders who established the Bipartisan Policy Center in 2007, Mitchell announced recently that the group would place national health care reform at the top of its agenda with a goal of making specific recommendations to the new president-elect and members of Congress before the end of the year.

At a press conference last month in Washington, Mitchell – who perhaps is best known as the man who brokered a peace deal in Northern Ireland after generations of violence – said, “I think we may have entered a period when, as to health care, the impossible may finally become possible.”

At the press event, Mitchell said he had heard many personal stories during a national “listening tour” in the 1990s.

“We heard from families who couldn’t afford health insurance and had spent down to poverty so they would be eligible for Medicaid to get care for their desperately sick children,” he said. “If we took a similar listening tour today, we would hear the same sorts of stories, but there would be more of them, and they would be even more heart-wrenching, because the problems are so much worse.”

All four of the policy center partners – the others are former Senate Majority Leaders Bob Dole, Republican of Kansas; Tom Daschle, Democrat of South Dakota; and Howard Baker, Republican of Tennessee – have strong, and differing, opinions about what needs to happen to fix American health care, Mitchell said Tuesday.

Co-directors of the policy center include Mark McClellan, who oversaw the Centers for Medicare and Medicaid Services and the Food and Drug Administration for President Bush, and Chris Jennings, a Clinton White House staff member and adviser to Sen. Hillary Rodham Clinton’s presidential campaign.

The plan is to convene at least four meetings around the nation to hear from health care providers and consumers, insurers, the pharmaceutical industry and others engaged in the health care debate before attempting to craft a unified set of recommendations for policy change. The first meeting was held last month.

“We hope to deal with this important issue and demonstrate that bipartisanship is still possible,” Mitchell said Tuesday. He underscored the need to keep an open mind in considering the compelling and often competing interests of health care stakeholders – including those who sometimes are vilified for their profit motives, politics or other characteristics.

“We shouldn’t be too critical of people in health care,” Mitchell said. “Everybody defines this issue through the prism of self-interest.” The goal, he said, is to “make it possible [for groups] to accept change in the context of the larger interest in which they share.”

And there is much to do. Reflecting the spiraling costs of new medicines and technologies, decreasing rates of insurance coverage, a growing disparity in the quality of care, and the power of entrenched industry groups, the U.S. health system ranked 37th in a 2000 World Health Organization survey of 190 nations. That ranking placed it just ahead of Slovenia, but behind Oman, Dominica, Chile, Saudi Arabia and many European nations.

A 2007 study by the Commonwealth Fund compared the U.S. with five other nations -Australia, Canada, Germany, New Zealand and the United Kingdom – and found the U.S. health care system ranked last or next to last on measures of quality, access, efficiency, equity and healthful lifestyles.

Trish Riley, architect of Maine’s controversial Dirigo Health reforms for Gov. John Baldacci, said Tuesday that she is encouraged that Mitchell’s group is taking on the gridlocked national health care debate.

The U.S. spends roughly twice as much per capita as other developed countries do on health care, Riley said.

“And we don’t get any better coverage or better care,” she said, speaking in a telephone interview Tuesday from a state health policy conference in Washington. “It’s simply unacceptable.”

Riley, who served as executive director for the National Institute for State Health Policy before joining the Baldacci administration, said many states, including Maine, Massachusetts and Vermont, have tried to achieve universal access to quality, affordable health care.

“But especially given the nature of our economy, a national solution is critically important,” she said. That solution must include measures for improving health care quality and coverage as well as containing costs, she said. Cost-containment measures must be linked to quality and access, she said, and might include regulating hospital spending and a “reinvention of managed care” to limit how much people use the health care system.

Riley developed the Dirigo reforms in Maine after convening the same kind of meetings at the state level that Mitchell’s policy center is holding on a national scale. She said she regrets not keeping participants engaged in an advisory capacity as the sometimes contentious reforms rolled out, because once the meetings stopped, many groups went back to protecting their turf.

“Dirigo’s been under fire since Day One,” she said.

The first of the national meetings took place April 24 in Washington and was chaired by Daschle. Mitchell said the next three meetings would be held in the home states of the other three majority leaders, including one in Maine, probably in the fall. Mitchell, who grew up in Waterville, now lives in New York but maintains a summer home on Mount Desert Island.

The group plans to develop its recommendations through the fall and will present its report after the November election but before the end of the year.

Mitchell said there is no assurance that the recommendations in the report will fall on receptive ears, but that some members of Congress already have communicated their interest and support for the project.

“It will be the quality of the report that carries it forward,” he said.

For more about the policy center and its health care agenda, visit www.bipartisanpolicy.org.

mhaskell@bangordailynews.net

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