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HEALTH REFORM: A Change is Gonna Come

December 9, 2008 - 3:50pm

As the song goes, we don't know much about history—unless you're talking top-20 songs from 1960 later covered by Herman's Hermits. That we got.

So this morning we checked out an event on Change in Turbulent Times over at the Center for American Progress to help put health reform in a historical perspective.

Presidential historian, Robert Dallek began the discussion by laying out the parallels between our current opportunity in health care and previous watersheds of reform. Noting the unifying effect of the economic crisis, Dallek thinks we're again in period of time that can produce the kind of monumental reforms seen during the New Deal and Civil Rights movement. Presidential leadership and early action are key, as is the ability to produce a consensus around reforms that are seen to benefit all Americans and not just specific interest groups. But, the one thing that can kill any reform, Dallek argued, was war. Citing examples from Vietnam back to the Spanish-American War, Dallek worried that escalation in Afghanistan could ruin Obama's chances of achieving major reform at home.

Chris Jennings, president of Jennings Policy Strategies, used to his experiences with the reform efforts of 1993-94 to provide a more recent historical perspective. He gave nine reasons he was more optimistic this time around, which we've summarized below:

  1. Leading economists now recognize that health care reform must be a part of our economic renewal package.
  2. The business community, so often the tie-breaker in any reform, is aggressively pushing health care reform.
  3. There is a new debate about quality and value that is fundamentally different from previous discussions which focused only on cost-containment.
  4. There is a growing understanding that any reform must address the uninsured and underinsured not just because it is a moral blight on our society, but because it is a necessary precondition to make our health care system more efficient.
  5. There is bipartisan support for health care reform, from Chairman Max Baucus (D-MT) on Senate Finance, to the Wyden-Bennett legislation, to the Bipartisan Policy Center
  6. Crisis breeds opportunity and the economic debate opens the door for broader debate on health reform.
  7. There's an important recognition that reform must take into account that while people don't like the cost of health care, they also don't want to lose what they have.
  8. There is an increasing understanding that comprehensive reform may be more viable than incremental reform from both a policy perspective and a political perspective.
  9. Strange bedfellows coalitions demonstrate that all stakeholders, not just consumers, business and labor, but also health plans, providers, and manufacturers, recognize that the baseline is unsustainable and that the reforms being talked about are workable.

We still don't know that much about history (or biology and the French we took), but CAP's event gave us hope that we're living at a time when real health reform is not only possible, but maybe even just a little bit more likely. Just think what a wonderful world that would be.