There are no winning or losing sides when it comes to reforming U.S. healthcare, said David Cutler, health advisor to Democratic presidential candidate Sen. Barack Obama (D-Ill.).
"It's just a question of how do we make life better for middle class Americans," Cutler said.
Cutler recently clarified the finer points of the Obama healthcare platform in a Kaiser Family Foundation "Ask the Experts" interview.
A professor of applied economics at Harvard University, he said Obama's plan proposes to build on the existing employer-based system while expanding public programs, putting into place new insurance regulations and providing new coverage options.
"We need to deal with healthcare in a different way than in the past," he said.
"Obama wants an open process with no secrets. He wants people represented in the debate who have never been represented before. Everyone gets a seat at the table. It needs to be a constructive give and take," Cutler said.
Larry Levitt, vice president at KFF and editor-in-chief of kaisernetwork.org, who hosted the interview, asked Cutler how Obama's plan could help reduce the national debt. Cutler said Obama's plan would include making an investment in healthcare information technology, making Medicare payment system changes, providing affordable healthcare coverage options to all Americans, emphasizing prevention and helping small businesses provide coverage.
"The rising cost of healthcare is affecting every part of society and is the leading cause of Americans going bankrupt," Cutler said. "We spend about $2 trillion a year on medical bills, with 40 (percent) to 50 percent of it not buying anything. We have got to be prepared to do the things that we need to do to free up that money."
To provide coverage to people with pre-existing conditions, Cutler said insurance companies would be required by Obama "to play by the rules."
"In order for a system like that to work, we have to have everyone in the system," Cutler said. "We believe the vast bulk of people will choose to buy insurance when it's affordable."