The first task has been checked off the list. Yesterday the Let's Get Healthy California task force met to go over the release of its draft report, the culmination of six months' work. The final report is slated for completion by Dec. 19.
"When you look at where we are today in California, there are so many challenges we're facing [in health care]," said Pat Powers, director of the task force. "The population is aging, there are unprecedented levels of chronic disease across the state, and alarming high rates of obesity and diabetes. For the first time in a long time, the children born in this generation may not live as long as their parents."
That creates a moral imperative to do something to meet all of those needs, Powers said. At the same time, the task force hopes to propose changes that not only improve care but save the state money, as well, she said.
Over the past six months, a core of roughly 100 people met monthly to work on creation of the draft report, Powers said, with input and comment from many more.
The strong attendance and participation thrilled task force co-chair Don Berwick, a former CMS administrator and past president and CEO of the Institute for Healthcare Improvement. "To have so many stakeholders attend is wonderful," he said, adding that their help was vital to producing the draft report so quickly.
"The chance to move from context to front line now, that's very exciting," Berwick said.
Co-chair Diana Dooley, secretary of the state Health and Human Services Agency, said the next step will be to develop a concrete action plan, once the draft report is finalized in December. The first step has been to identify the areas that need to be improved, and decide what metrics can be used to pinpoint progress over time.
The purpose of yesterday's meeting, Dooley said, was to raise questions and concerns about the draft report -- what needs changing, or what might need to be added. "We wanted to present an overview of all of this," Dooley said, "and then begin to drill down on some of these details."
"There's lots and lots of good stuff in here. What I'm thinking about is what's not in here," said Dave Regan, president of Service Employees International Union. "I keep going back to two things -- 80% of what drives health care costs is behavioral, and only 20% of the cost of health care can be affected by what we do today."
Regan said there needs to be a bigger change, a cultural change, to affect some of the root causes of rising health care costs and poor health of Californians.
"When you look at the goals and indicators in here, we may have a forest-and-trees effect. The behavioral culture is far more influential than all of us nibbling at the margins. … Unless we change the behaviors of millions of people, then we're just tilting at windmills."
Regan proposed working with schools as a focus point for change in health care patterns.
Dooley strongly welcomed that line of thinking. The current report, she said, focuses more on an overall health care policy strategy, and the specifics of what can be done to accomplish the outlined goals comes later.
"What this work is not
," she said, "is this is not state mandates or figuring out ways the state can step in and make lives better. But the idea is we can be a vehicle or conduit for people to make their own lives better."