We’re the only major industrialized nation that does not have a budget for what it will spend on healthcare this year. Or so David Walker, the former comptroller general of the United States, told me during a recent phone interview. Walker, currently CEO of the Peter G. Peterson Foundation, has been outspoken for years about the country’s growing deficit, and the lucidness of his commonsense oratory has long made him a favorite among rank-and-file comptrollers - a fact that has helped Walker garner some impressive speaker fees on the F&A lecture circuit.

We titled our interview “The Comptroller Who Roared,” in part because comptrollers have not traditionally been thought of as being particularly loud or thought-provoking. The conventional wisdom is that comptrollers deal in day-to-day realities and should be best known for their level heads and sensible solutions.

So when David Walker talks, comptroller heads will turn. And when it comes to healthcare reform, Walker as always stands ready with a list of to-dos.

Walker’s list:

• Impose a budget on what the federal government can spend on healthcare each year.

• Move away from fee-for-service systems and jury trials for medical malpractice suits.

• Better target tax preferences for employer-provided and -paid healthcare.

However, healthcare reform continues to worry a good many finance leaders as they seek to gain a better grasp on costs that continue to steal dollars from other opportunities. Indeed, the idea of spending money now for an uncertain future return on investment remains a difficult pill for most CFOs to swallow.

As revealed by a recent Business Finance study titled “The Role of Finance in Managing Healthcare Costs,” finance executives see deficiencies in the proposed healthcare reform legislation, and a majority (61 percent) believe that the legislation lacks personal responsibility for health.

Meanwhile, over half of respondents indicate they are less optimistic about healthcare reform than they were even last year. Now, to be fair, I should mention that our survey was conducted within the first ten days of January. And I guess we would all agree that the political climate seems to have changed, and who knows even what tomorrow might bring.

However, finance needs to borrow a page from its favorite son, and moderate its knee-jerk reaction to reform measures. As usual, Walker is out in front. ###