Looking Back and Casting Ahead

Although Dave Durenberger didn’t leave office under ideal circumstances, the former U.S. senator, current chairman of the National Institute of Health Policy and Senior Health Policy Fellow at the University of St. Thomas has managed to remain relevant and civically active since. Here are his opinions on leadership and our current national circumstances.

By Dave Durenberger

Community Service
» In the H.B. Fuller days, before my election to the Senate, community service meant corporate social responsibility work at the St. Paul Chamber, the 5% Club in Minneapolis and the metro, work on a major Citizens League project involving private-sector alternatives to public service delivery. That started privatizing garbage collection and school lunches and led to charter school creation and employee health plan choices in [the Twin Cities]. Everyone, including corporate execs, was into community service. Today it seems more focused on charitable organizations and activities rather than community and civic time commitments that actually enhance the community's future. My current work is principally related to providing leadership to those who would improve the quality and reduce the cost of health care.

» The first leadership lesson is that if you ground your character and your persona in a belief system you will find and know when to seize opportunities to change yourself and others. Second, leaders are usually persons with a vision of what could be or what should be, grounded by a personal faith and the experiences that result from stepping out and doing it. They have spent time in community service, where what they think is the right thing to do has been tested against the views and the reactions of others. Third, as long as I can remember, I've been asked to be the "person in position of leadership," and learned from that how to earn it by performance. The U.S. Senate was a great testing ground. To be a leader was more than rising in the chairs. You found an issue others were reluctant to tackle, you informed yourself by seeking out consensus experts, on both sides of the issue, and both sides of the aisle. Thus, you found the path least travelled but most would like to travel.

While my greatest satisfaction comes from my family and close friends and their success, my best legacy is the thousands of people who have told me since I left public office that they are grateful for my service, wish I were back there, and, especially, that they want me to know specifically how I made a difference in the lives of someone in their family.  The greatest challenge is that I had an opportunity to build so many relationships with so many people who were so good to me and for me, that in my present life I miss the chance to say thank you and spend time with each and every one of them.  So I'll die trying.

» On September 17, 2008, the day President Bush and his Treasury Secretary decided they needed to persuade Congress to help them save the world's financial institutions by "bailing out" our own, the economy in which I had grown up and done quite well, thank you, came to an end. The new economy is as yet to be defined, but it will be an economy not built on real inflation nor the artificiality of inflated expectations. Government leaders are obliged to begin a national dialogue involving each generation of Americans on what this means. Government must engage in reforming health care, education, energy and environment policies. It must also engage us in tax policy reform and economic security policy. It's time for a "New Federalism," in which we redesign the roles and responsibilities of our national, state and local governments and their fiscal capacity to meet our needs in much better ways than they have.

Health Care
» The health reform law passed by the Congress in March signals the beginning of a commitment to reducing the cost and increasing the quality of health and health care for all Americans. Despite the rather intense political opposition to the law, no American should be angry that the richest nation on earth has finally made a commitment to providing access to care for all its citizens. The costs of doing that should be a third less than is currently anticipated, because estimates are based on little or no change in a medical industry that currently collects $2.5 trillion for about $1.7 trillion in real value. Insurance reform will go part-way toward achieving the new value goal. But without leadership from the health professional community, especially physician leaders, we cannot accomplish all that is possible. Government and private purchasers and payers are obliged to change the financing system so that it rewards professional leadership that demonstrates greater value.