Editorial

Well, they certainly surprised me.

For the political junkies among us, the acronym SCOTUS (otherwise known as the Supreme Court of the United States) has practically become a household word. By now, oceans of ink have been devoted to media coverage of the Affordable Care Act (ACA), the 3 days of unprecedented legal hearings and speculation about the potential outcome to be announced sometime in June. My colleagues in health policy circles have been making friendly wagers, not just about what the ultimate decision will be, but how the actual vote count will fall.

It is with a great deal of pride and humility that I have accepted this new role as the Editor-in-Chief of American Health & Drug Benefits (AHDB). Let me outline what I hope to accomplish in the coming months and years and solicit your input and support. First, some background about my professional journey. I have been at Thomas Jefferson University for the past 22 years. During that tenure, I have had essentially 3 jobs. I came on board in 1990 in a staff role to the hospital CEO, directing the Office of Health Policy.

In June 2008, my wife and I moved to downtown Asheville, NC, with our dog, Max. Max and I were out for a walk early every morning and late every evening. When I first started taking Max for walks, I would occasionally notice people who appeared homeless, and I became curious about the causes of homelessness and its solutions.

It is difficult to believe that 5 years have passed since the first issue of American Health & Drug Benefits (AHDB) arrived on my desk in 2008. In February 2008, the United States was on the verge of an economic downturn that had actually begun almost 3 months earlier. The price of oil topped $100 a barrel for the first time, and job losses were just being reported. Although most of us did not know it yet, the United States was entering the worst economic downturn since the Great Depression.

Daniel G. Garrett, RPh, MS, FASHPIt is only 75 miles from Asheville, NC, to Hickory, NC.

The infuriating reality of healthcare is that it must be run in a systematic way, and that one aspect of that system must be policy (the other 2 are clinical and business). And of course, policy means that politicians ultimately weigh in and “decide” things fundamentally outside their areas of expertise. Not known for consistent fiscal brilliance, their stamp on healthcare often means that much of the downstream effects of legislation consist of crisis management aimed at containing the clinical or economic ruin the legislation overlooked during the planning phase.

New clinical, business, and regulatory healthcare systems are offering unprecedented opportunities for providing quality and value. At the heart of the healthcare debate lay evidence, balance, and competing incentives in search of a point of consensus. Data are poorly understood and do not speak for themselves. Cooperation between stakeholder groups is still elusive, with stakeholder polarization strong, de spite the urge to unite forces. The healthcare system is circling around looking for an organizing principle.

As more and more American families find their budgets pinched by the ever-rising cost of healthcare and a growing volume of scholarly research convinces health policy experts that the quality of American health too often falls short of what it should be—given that Americans spend about twice as much per capita (in purchasing power parity dollars) on healthcare than its neighboring Canada—it is inevitable that the topic of health reform will have a prominent place in the forthcoming presidential elections.

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