Politician-physician John Kitzhaber says he isn't running for president, but he's working hard to influence those who will. The former two-term Oregon governor, who practiced emergency medicine for 10 years while serving in the state Legislature, has a plan to put healthcare reform on the national agenda in 2007 and affect the 2008 presidential campaign in the process. "I really do believe there is a narrow window to exert control over this thing," he says. "I'm going to be engaged in this really hard for the next few years and see how far I can push itâcertainly up to the 2008 election."
Under the banner of the Archimedes Movementânamed after the ancient Greek mathematician/engineer/astronomerâwhich he launched this past January, Kitzhaber plans to get Oregon and other states to request from Congress a broad set of Medicaid waivers "to challenge the U.S. healthcare system." (See related story, p. 22). "I'm convinced that, if we had this large set of waivers (before Congress) you couldn't run for president without having a position on them," Kitzhaber says. "It forces Congress to either say 'We'll let you do it,' or forces them to defend the current system. â¦ It certainly strikes terror into the hearts of some people."
Kitzhaber, 59, cites three federal programs as being at the heart of today's problems: the 1954 legislation that created a preferential tax system for employer-funded health insurance, which he says puts U.S. companies at a disadvantage in today's global economy; and the creation of Medicare in 1966 and Medicaid in 1967, which create such anomalies as healthcare for wealthy retirees subsidized by the working poor. "Our demographic environment has changed dramatically, but these programs still reflect the climate of the middle of the last century," he says.
Kitzhaber's vision is to reallocate the public dollars currently spent on healthcare and use them in a way "that ensures universal access to a defined set of effective health services." In defining his strategy, he quotes the American architect/philosopher Buckminster Fuller, who said: "You never change things by fighting the existing reality. To change something, build a new model which makes the existing model obsolete."