What does automobile inventor Henry Ford have to do with health reform?

Gov. Tim Pawlenty and former U.S. House Speaker Newt Gingrich each touched on Ford’s entrepreneurial history Wednesday to explain why they think health reform will require a lot of transformational leadership and innovation and a minimum of government bureaucracy.

The Republicans spoke at a conference on "Creating a 21^st Century Intelligent Health System in Minnesota," sponsored by Healthways.

Gingrich, founder of the 6-year-old Center for Health Transformation, said "disappointing is the No. 1 word" to describe the 1,000-page bill (here's a summary) introduced by Democrats on Tuesday in the House of Representatives.

"We’ve been told now for months that we have to deal with health care because it’s too expensive; it’s a crisis for the economy ... so now we’re going to spend $1.5 trillion more than we’re spending ... and we have no innovation in the system," he told conference attendees at the University of Minnesota’s McNamara Alumni Center. "It is entirely about control, power and more government. There are 31 new federal agencies in the bill. ... What an extraordinary lost opportunity."

But back to Ford and reform. Pawlenty started the ball rolling.

Taking risks
Ford once said that if he had asked potential customers what they wanted before the advent of the automobile, "he was quite confident the survey would have come back with ‘more horses’ or ‘faster horses’," Pawlenty said. "The idea of innovation does not center around the pulse of what people want because most often they will say they want more of what currently exists. The ability to envision a different and better future is one of the challenges of leadership.

"Our health care system is fundamentally broken," Pawlenty said, "and the answer is not more horses. The answer is not faster horses. ... We cannot take the current delivery system and simply speed it up, or subsidize it some more, and expect that to get us where we need to be as a nation or a state going forward."

Gingrich, at one time a history professor, said Ford is one of his "favorite examples" of why he thinks government needs to get out of the way of innovators and inventors. He related how Ford would finish his day job as a foreman at the Edison electric company in Detroit, then work on his first car at night in his garage. This was in 1899.

"Ford built a car which was wider than the doors of his garage, and he literally had to knock down one wall of the garage to get the car out. This is typical of how real innovation occurs. In real innovation, you don’t know enough to plan very carefully because it’s genuinely new and different," Gingrich explained.

To test-drive the car, Ford and a friend only went out at night because they wanted to "minimize encounters" with horses. Instead, they had an unfortunate encounter with a pedestrian, resulting in the first pedestrian accident involving an automobile. "The car was so light, he and his friend got out of the car and saw the front wheel resting on the pedestrian’s chest and they discussed with the pedestrian whether he thought it was better to lift the car straight up or finish rolling it over.

"I’ve always thought that if modern trial lawyers advertised on TV back then that Ford would have been bankrupt from that very first experience," Gingrich said. Later in his address, he said, "Imagine if Henry Ford had to go to Washington to get a permit to build his first car ... or if had to get permit to run his first assembly line."

Challenges of reform and access
But back to health reform and creating a 21^st century intelligent health system in Minnesota. After ticking off some of Minnesota’s successes such as being one of the healthiest states in the nation and having one of the lowest uninsured rates, Pawlenty spoke about the challenges of reform.  

"There’s a great momentum in the country, as there should be, to try to expand access," he said. "But, keep in mind that it’s a solution for about 8 percent of people who are uninsured. But an equal, if not greater, crisis around the issue is how the other 92 percent of the population afford the insurance they have or afford their insurance going forward. ... An undue emphasis on access-only -- without an equal or greater emphasis on cost control -- is a recipe for disaster."

Cost control is needed, up to a point. Pawlenty said planning reform around the cost structures of Medicare reimbursement rates would be harmful to Minnesota, which receives "substantially lower reimbursements" than other parts of the nation. "Places like Minnesota that have been innovators, that have been efficient, that have been pioneers, are going to get dramatically punched under such a scheme."

Gingrich said his center was founded as a nonpartisan effort to promote more health care choices and lower costs. Over the years, he said the center has worked with Democrats including Patrick Kennedy, John Kerry and Hillary Rodham Clinton.

"We really believe we can put together a solution-oriented, innovative bipartisan bill that raises no taxes," he said. "We don’t need to raise taxes. We need to have a dramatically more effective system ... we ought to be able to save enough money with the right insurance reform ... to cover everybody in the system."