From Chatter, To Ideas, To Action: Humana’s Change Now 4 Health Campaign

In late 2003, Congress funded a potentially powerful initiative designed to engage ordinary Americans in a dialogue about health reform. This project, The Citizens’ Health Care Working Group (CHCWG), was funded along with the controversial Medicare Part D program.  It was designed to ignite a national public debate about how to improve the US health system so that “every American can obtain quality, affordable healthcare coverage.”

Beginning in 2005, 14 people, handpicked by the US Comptroller
General held a series of meetings with ordinary Americans (the
Secretary of Health and Human Services (HHS) served as the 15th
member).  In addition, thousands of Americans chimed in online with
their ideas for changing the system.  They made the following recommendations:

-Establish Public Policy That All Americans Have Affordable Healthcare

-Guarantee Financial Protection Against Very High Healthcare Costs

-Foster Innovative Integrated Community Health Networks

-Define Core Benefits & Services For All Americans

-Promote Efforts To Improve Quality Of Care & Efficiency

-Fundamentally Restructure The Way End-of-Life Services Are Financed & Provided

September 2006, the Working Group delivered its recommendations to
President George Bush.  In March, the president responded by rejecting
CHCWG’s proposals.

HHS Secretary Mike Leavitt explained the president’s decision, saying
that Bush agreed with many of the Working Group’s goals.  However, he
“supports an approach emphasizing consumer choice and options . . .
rather than mandates and government intervention.”

Fundamental Healthcare Reform: Forever Stuck On Neutral?

response to the Working Group’s proposals highlights a key barrier to
fundamental healthcare reform.  There are serious differences between
many groups on how to radically change the system, which creates almost
insurmountable logjams.  As William Roper, dean of the University of
North Carolina School of Medicine, observed in the latest edition of Health Affairs:

lesson of time, at least in quarter-century increments, is that the
United States is fundamentally conservative in its view on changing its
healthcare system.  Despite talk then and now by health policy elites
about ‘fundamental reform,’ most changes in the U.S. healthcare system
have been incremental.”

I agree with Roper.  Unfortunately,
fundamental change will remain stuck on neutral for the foreseeable
future.  Yet, we still have urgent problems that demand answers and the
clock is ticking – in more ways than one.  In another essay
published in this month’s edition of Health Affairs, Leonard Schaeffer
suggests the usual suspects are running out of time to shape policy.
He thinks, “budget hawks and national security experts will eventually
combine forces to cut health spending, ultimately determining health
policy for the nation.” We must not allow this nightmare scenario to
come to pass.

Although CHCWG Hit A Brick Wall, Is People Power Still The Answer?

CHCWG failed to gain traction, getting the masses involved in reform
efforts is a good idea.  However, we need to quickly move from
attempting to broadly shape health policy to immediately implementing
concrete ideas for change.  Fortunately, enterprising individuals,
corporations and government agencies from across the country are
chipping away at the system’s problems.  Unfortunately, these ideas
often do not catch on nationwide because we don’t know about them.

This is where Humana comes in.  On November 19, the health company will officially launch Change Now 4 Health
(CN4H), a broad, grassroots coalition committed to improving the
nation’s healthcare system through immediate action.  Although launched
in the shadow of CHCWG, Humana is not reinventing the wheel.  Rather it

-Using Web 2.0 tools including blogs and online forums to
form communities of change-oriented individuals to address specific

-Doing its best to encourage rapid action rather than
more recommendations for change that may or may not be implemented by

-Using the wisdom of crowds to focus national attention on solutions to our shared problems

-Allowing the community to come up with ideas rather than trying to control the conversation

course, the biggest question is whether Humana can credibly manage this
effort.  If it were trying to control CN4H from above, the answer would
be no.  Instead, the company is doing something revolutionary (for the
health industry).  It is providing the platform for CN4H, but leaving
it up the community to determine its own direction.  Humana is putting
its trust in the collective expertise of the public to determine its
own course.

How Will CN4H Move Beyond Talk To Action?

Ultimately, Humana hopes to generate concrete ideas by facilitating three levels of online dialogue about reform:

Level 1 – High Level Issues:
Humana has recruited a number of individuals (I am one of them) to
develop blogs on key problems facing the health system.  While we are
being compensated for our time, Humana is leaving editorial control of
the blogs to us.  My blog focuses on how we can help consumers make better health decisions.  Humana has not edited or censored any of my blog posts.

Level 2 – Concrete Ideas For Change: This month, Humana will launch a series of online forums where individuals can discuss ideas for change.

Level 3 – Idea Submission & Discussion:
To encourage public comment, Humana will produce an online form where
people can submit their ideas for changing the system – today.  These
ideas will be funneled into the bulletin boards and discussed on the
community blogs.  Also, community participants will be able to vote on

Spreading Ideas For Change

Humana has
committed to help spread the ideas generated by the community in a
number of ways.  Most importantly, the company will fund the production
of an e-book, tentatively titled “50 Ideas For Changing Health Today.”
The fifty ideas receiving the most votes by the community will be
featured in the book.  This free publication will be made available on
the CN4H Website and major online book retailers, such as Barnes & and  Humana will also distribute the book to
stakeholders in both the public and private sectors.

CN4H: Putting The Wisdom Of Crowds To Work

decided to become involved with this effort for many reasons.  (And,
although it is nice to be compensated for some of my time, money had
very little to do with it.)  Most importantly, I am a firm believer in
the power of the wisdom of crowds to solve the most complex and vexing
problems – health reform certainly qualifies.  In addition, I have been
frustrated that previous efforts to change the health system have
resulted in a lot of sound and fury, but very little action.  We need
reform now, and our collective wisdom and intellect can make a real

I encourage everyone reading this post to:

Visit The CN4H Community Website:
Currently, the site features blog posts, but Humana will be deploying
additional tools and features at and after the program’s launch

Spread The Word:  We are relying on the online community to shape the program.  Please help us by spreading the word about CN4H

Discuss, Submit & Vote On Ideas:
Help make the e-book “50 Ideas For Changing Health Today” a reality by
discussing, submitting and voting on ideas generated by the community

I look forward to seeing what we can do together.

Fard Johnmar

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