In mid-2005, many progressive thinkers felt disengaged from the political process. An idea of forming a new space for civic engagement began, one that wasn’t connected to political parties or legislation.
Each day more Americans risk losing their access to health care. This challenge requires an American solution that invests in our health while guaranteeing all families affordable, quality health care. We began with a set of assumptions about the current system, describing the patchwork of different federal, state and local programs involved in delivering health care services. Inability to control the rising costs of health care and health insurance has placed our nation at risk, put businesses at an economic disadvantage to other countries, and left many people without access to care.
As community members understood the inherent problem, they began to see why the objective of health should drive reform. They saw that our health status has more to with where we live, how much we earn, education level, and our diet, exercise and other behaviors. Ultimately what Americans want is to be healthy, not to get sick and need medical care.
In January 2006 we held a press conference, were our founder, former and current Oregon governor John Kitzhaber, MD, said “The problems we face are about us. And they cannot be solved unless we do it together. The fact is that unless the people themselves can agree on a broad vision for what they want the U.S. health care system to look like; on the values they want it to reflect and the outcomes they want it to produce, the political process cannot and will not do it for them.”
We launched an interactive website and held meetings in eleven communities around Oregon. More than 3,000 people gave input on refining a set of principles. At each meeting, and online, the participants talked to each other and came to agreement on how they wanted the principles revised. It was a very robust process which resulted in a set of fifteen shared principles.
Next, participants crafted a framework for a new delivery system, and then – and only then – we began to leverage policy makers and political leaders to draft legislation. Rather than working from the political process out, we started in communities and worked from the ground up. Fourteen of the principles drafted and refined by more than 3,000 Oregonians were included in SB 329, passed in 2007.
In 2008, we held an inaugural conference and endorsed the Triple Aim, described by Don Berwick, MD, then director of the Institute for Healthcare Improvement. In the Triple Aim, the key objectives are described that will transform the health system – improved health of a defined population, lower per-capita costs, and a better experience for those who use the system. We were the first grassroots, non-clinical organization to endorse the Triple Aim.
In 2009, the Oregon Legislature passed House Bill 2009, which created the Oregon Health Authority, and the Oregon Health Policy Board. Both entities have adopted the Triple Aim to guide their work, which is a testament to the grassroots work of We Can Do Better, supporters and allies. But the work has only begun.
With passage of federal health reform in 2010, the Patient Protection and Affordable Care Act, community engagement is even more critical and more opportunities exist to influence implementation. Our 2010 Conference was focused on the Triple Aim, specifically how we would define an improved experience of care.
We hold the same belief we had when we launched – there is more to health reform than what happens within the medical system. The services that take care of us when we are ill or injured are critically important, but in order to achieve the Triple Aim – we must invest in things that promote and maintain health. We believe we can do both – create a more effective, efficient and sustainable health system, while also investing in the health of our communities and the generations to come.
We believe We Can Do Better.