The prescription for curing the nation’s ailing health-care system is to take reform one step at a time, says a health policy expert at Northern Arizona University.

Paul Dutton believes successful reforms will take years to implement, “but the politics of the matter aren’t permitting a parsing of reforms into sequential steps.”

Dutton is a professor of history and executive director of the university’s Interdisciplinary Health Policy Institute. He is working to educate the public about health-care issues so informed decisions, and progress, can be made. “I believe that U.S. competitiveness in world markets and our standard of living will suffer irreparably if we don’t meet the health-care challenge, and quickly,” Dutton says. “We can’t afford another 15 years of dithering.”

Paul Dutton

Author of Differential Diagnoses, A Comparative History of Health Care Problems and Solutions in the United States and France, Dutton’s knowledge about health-care issues is being sought worldwide. He’s a regular on the radio talk-show circuit, gave the commencement address at Brenau University in Georgia last spring, and is the keynote speaker for the European Studies conference at Duke University in November.

He says the Germans and French are coming out of the recession faster than the United States in part because their taxpayers and employers spend only two-thirds as much as America on health care.

“Meanwhile, we have a system in which between 25 and 45 percent of workers are ‘job locked’ for reasons related to health insurance. A very large proportion of the U.S. workforce will not leave current employment because the worker, or his or her dependant, has a pre-existing medical condition, and is fearful that the condition would be excluded from coverage under a new plan,” Dutton notes.

“A would-be Bill Gates might at this very moment be saying to herself, ‘I can’t afford the risk of starting my own company. I’ve got a kid with diabetes’. I wonder how many more Microsofts this country would have had by now—all the jobs, wealth creation, spin-off industries and innovation if it weren’t for this crazy health-care system we have.”

Dutton suggests in order to be successful, U.S. health care must address coverage, cost and quality, but the fact that they are interconnected make the politics of reform extremely complex.

Dutton’s recent book points out what is working right with health care in France.