R. Clayton McWhorter says he's been around long enough to see little meaningful reform of health care follow election-year promises of presidential candidates.
He's also seen politicians reach out to young Americans in election years, only to stop communicating with them once the outcome is decided.
With this year's presidential contest approaching, the veteran Nashville health-care executive and entrepreneur decided to set up a nonprofit group to give young people a voice and inspire them toward an ongoing role in finding potential solutions.
Through Tuesday, SHOUTAmerica is hosting 100 student government leaders from around the country here to discuss health-care issues.
It's among grassroots efforts starting in Nashville whose organizers are using events pegged to Tuesday's presidential debate on the Belmont University campus between Republican John McCain and Democrat Barack Obama to shine a spotlight on what they consider a top national issue.
"We think we've got a crisis in the banking system, but we're going to have one in health care and might as well be working now to find a solution," said McWhorter, who has helped to start many companies after a career in hospital management.
Most experts expect gradual tweaks of the nation's health-care system in the next four years, not sudden, comprehensive reform. That seems especially likely after Congress passed a $700 billion financial markets rescue package last week.
Former U.S. Senate Majority Leader Dr. Bill Frist expects increased funding for children's health insurance but cuts in funding for private Medicare plans. He also expects Congress to approve the development and sale of drugs made from biological products and expanded stem cell research.
There also could be a move to let the government directly negotiate prices with drugmakers under Medicare's prescription drug benefit, said Frist, who will act as moderator of a panel discussion on health-care reform and the election to be hosted by the Nashville Health Care Council on Tuesday.
"If McCain wins, we'll see more market-oriented principles," Frist said. "Obama's focus will be on expanding coverage, moving toward universal care."
With Nashville as a headquarters city to more than 300 health-care companies, many decisions are made here that shape the industry's future on such topics as caring for the nation's 47 million uninsured and trying to rein in costs.
"There's a general feeling that Obama would benefit hospitals because having fewer uninsured would reduce the bad debt," Frist said. "It's a general feeling McCain would benefit the health plans because of competition using the private insurance market."
Nashville has lead roleTraditionally, Nashville's health-care community has favored a market-oriented view, said Paul Keckley, executive director of the Deloitte Center for Health Solutions in Washington. Now, there's more interest in the government stepping in through employer mandates and universal coverage.
"When government becomes a bigger part of the solution, it typically comes with increased regulations, something a lot of folks are going to have to give a second thought," Keckley said.
McCain's market-oriented approach has its share of critics, including Tony Garr, executive director of Tennessee Health Care Campaign, an advocacy group.
"We need to devise a program where you're guaranteed insurance coverage for everyone," Garr said. "For the insurance market to work, it needs more regulations."
Garr expects a good turnout at downtown's Legislative Plaza on Monday for a grassroots rally for national health care themed as "Cover America Now! Together We CAN!"
"If you want to help address the credit crunch and other issues going on with the economy, then you also have to address the health insurance issue, because people are paying for their medical care on their credit cards," Garr said.
David Osborn, executive director of Health Care Solutions Group, a local think tank with ties to Vanderbilt University, said neither candidate has said much about what to do about Medicare going broke or how to create a real primary care system.
"Even if we have (universal) coverage, we don't have enough primary care doctors to take care of those people that would now have insurance," Osborn said.
Realizing a long-term solution won't come from his generation, the 75-year-old McWhorter said he started work on SHOUTAmerica a year ago. Former White House staffer Landon Gibbs, 26, was recruited as executive director to help launch it.
McWhorter has his own thoughts about health-care reform, but said that he sees the group as a forum to get young adults (ages 18 to 34) up to speed on the issues so they can spread information on their campuses.
Separately, McWhorter also leads a group of "thought leaders" called the Rolling Hill Group set up by the Tennessee Hospital Association to create a health-care reform plan for the state. It's expected to release recommendations next month.
That effort aside, McWhorter said he's excited about getting involved with young people through SHOUTAmerica.
"I just really believe people like me have an obligation to try to make a difference," McWhorter said. "We might not make a difference or do doodly-squat, but I just believe we will. I have a lot of faith in this younger generation."
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