Why Health Reform is Nothing like the Chilean Mine Rescue Effort

As the world watches the rescue of 33 miners trapped underground for more than two months in Chile, I couldn’t help but think of how different the effort has been from the passage and implementation of health reform in the U.S.

Leadership, then cooperation
The President of Chile, Sebastian Pinera, has made the rescue a top priority. No doubt, numerous case studies will be written in the coming years highlighting both his successes and failures as he dealt with the crisis. But as it looks right now, President Pinera got in front of the issue immediately and he did something we rarely see in politics today: he led! He made a decision to save the miners, which made planning a much easier task because everyone understood what they were trying to accomplish. The list of cooperative efforts is truly staggering - between other countries, public and private entities and different types of experts. The cooperation flowed from the strong leadership, it didn’t magically appear on its own. President Barack Obama’s strategy for health reform was not to direct the effort, but to delegate to Congress. Cooperation was not forthcoming, as we all know.

Putting practical considerations before expert opinions
NASA and the Chilean Navy worked together to create the rescue capsule. Why them? Because they had the practical experience necessary to do something that’s never been done before. Practical experience trumped expert opinions. When I say expert I mean an authority, not just someone with specialized knowledge. Does NASA or the Chilean Navy know more about mines than local engineers? Not a chance. However, they do know what it takes to build specialized containers that move through difficult terrain that can also hold humans safely. Practically speaking, the effort needed drills and drill bits, drilling rigs and steel pipe and vital signs monitors. President Pinera needed to know how to rescue the miners, not how he should rescue them. Health reform on the other hand, has been built by policy experts, not by patients certainly, and not by families and friends who help patients navigate the system.

Effective use of public relations
Live video and sound feeds, both below and above ground. The prominent placement of the Chilean flag in front of the flywheel apparatus that cameras all over the world are focused on. When the cameras pan, you also see the friends and family of the miners and rescue workers, the logos of companies who helped, and the flags of countries who donated supplies and technical expertise. The message is loud and clear. We are Chile. We are taking care of our own. We take pride in leading a truly cooperative effort. The Obama administration has said repeatedly they have a communication problem when it comes to health reform. Their communication approach matches their health reform policy: we gave a little bit to everyone. No one loses, but no one wins.

Utmost focus on the goal
Bringing the miners above ground, alive, and as healthy mentally and physically as possible, has been the utmost goal over the past 69 days. Seems simple really, but Chile could have focused on who was responsible for getting the miners trapped in the first place, or on who should pay, or on which agency should be permitted to perform which part of the rescue effort, but they didn’t. They focused on the goal. In the U.S., health reform changes who is responsible and who is allowed to do what. Maybe if the policy had the utmost goal of helping patients instead, the entire U.S., and maybe the world, would be cheering as they are for the Chilean rescue effort.