Q&A: Ralph de Cristoforo

As the coordinator of a project called Health for All, clearly Ralph de Cristoforo promotes universal health coverage. Yet while he advocates health-care access as a universal right, he also views health care as an individual responsibility.

INLANDER: What’s the biggest problem facing health care today?
DE CRISTOFORO: The biggest problem in health care today is it’s not health care as it should be: comprehensive health care for everyone. We look at values surveys that we’ve done across the country, and everybody seems to agree, it doesn’t matter if you’re a Democrat, Republican, Socialist, Libertarian — everyone should have access to affordable, appropriate health care at the appropriate time.

We have to understand that health care is an economic development issue. I equate it to education with children. When we started public education, it was for the economy, not because we cared about children. It was to build an educated work force. Health care serves the same purpose — support for a ready-to-work workforce.

What does reform look like to you?
We need to look at transparency in the health care system, and in the health care finance system. We need standardization across the board — not government control across the board. So that people could look at a policy, and it [would be] understandable and would be the same in Washington as in Florida. As it is now, even two policies from the same company are hard to figure out. We need some consistency.

The key is to develop a system with more primary care doctors and nurses. We’ve known there’s a shortage for the last 10 years. We have to convert a sickness system to a wellness system. And we need to reform financing, so it’s not per service.

Say you can’t accomplish all those things. What are the most important incremental steps in the right direction?
We need to regulate and monitor transparency and standardization. That forces competition in cost and customer service. With the pharmaceutical industry, there’s already a lot of behind-the-scene handshakes going on. We need to work on those. We should also remember that it’s the people of this country who are often supporting their research. A lot of their money comes from the National Institute of Health and the research comes from public colleges, which are financed with our tax money already. So we’re actually paying for medication again after we paid for its development.

The option of a public plan is worthwhile. I equate it to education. Public education is a standard but not a baseline. The education that’s given to children, if they use it properly, will guarantee their success for the future. People can spend more money for what they believe will be a better education, but people can also spend more money and get worse education. But everyone should have access to that standard, in health care as in education.

How do we measure the success of health care reform?
Well, a lowering of the use of the emergency room for primary care. That would be a standard right there. A lessening of intensity of some of the treatments needed because of the primary care that the uninsured don’t get. They’ve waited too long, so the level of care is always higher. Catch the cough on the first day, rather than the fifth day when it’s walking pneumonia.

Employment. People being ready and able to work. Attendance in school, the ability of children to learn. Talk to any teacher and they can point out who doesn’t have access to health care, because they’re the children who are always missing school.
Are you optimistic for reform?

I was optimistic in the beginning. I started to lose the optimism when I saw the watering down of the concept of comprehensive care for all citizens, the amount of money being spent on daily lobbying efforts against meaningful reform.

Also, people, as we’ve found, are media-driven. If they see it, they believe it. People are responding or speaking out without thinking about what they are seeing and hearing. If somebody says that seniors are going to have to have mandatory end-of-life counseling every five years, they believe it. And that’s nowhere in [the legislation]. The lack of the public thinking through what is being said is what concerns me.

If we don’t get it right now, then what?
If we get it wrong now, it would be a long time before we get it right. It’s taken 10 years to get it back on the front burner. Unfortunately, it’s happening at the same time as our current recession, but that’s all the more reason we need health care.