February 5, 2024 It's an old joke, and though I made a reasonable effort to track down the original source, I failed. However, I did find that early versions of it, dating back to at least 1930, centered on indecent proposals for sex. Not surprisingly, and nearly a century later, the anecdote often is aptly applied to policy dealmaking negotiations in legislative bodies across America. Skipping the indecency of the set-up, this is a family friendly column after all, a version of the punchline goes like this: "We've already established what we are. Now, we're just haggling over the price." Healthcare debates in the Indiana Statehouse are primarily an exercise in "haggling over the price." But like the original version of the joke, the more important part of the debate really is the "establishing what we are" part. Whitney Downard, reporter for the Indiana Capital Chronicle, succinctly reported last week on a hearing of the Indiana Senate Committee on Health and Provider Services that featured five legislative proposals moving forward that were almost entirely about the price. The bills dealt with financial incentives for patient referrals, tracking the average negotiated charge between healthcare providers and insurers, non-compete agreements for physicians, prior authorization of care by insurers, and finally, two bills regarding pharmacy benefit managers, or PBMs. Whew. I read the story several times and still don't see the part about Hoosiers getting healthier. The most important part of the healthcare debate often doesn't even come up in the rooms where decisions are being made: What can we do to live healthier lives? Anyone who believes that either Indiana or America will magically become healthier by resolving all the debates about price first, should also be shopping for Jack's beanstalk beans. Establishing "the price" isn't the mission. Improving the public's overall health is.   Connect with Michael Leppert Visit michaelleppert.com to read the full post and links to any resources or articles mentioned. Twitter @michaelleppert  Facebook at Michael Leppert Michael Leppert is an author, educator and a communication consultant in Indianapolis. He writes about government, politics and culture at MichaelLeppert.com. The views and opinions expressed are those of the author only and do not necessarily reflect the views of The Indiana Citizen or any other affiliated organization.      

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