HEALTH REFORM: Prospects Remain High for 2009

This post appears on the National Journal's Health Care Experts Blog where you can also see what other health policy analysts have to say on Health Information Technology.

The prospects for health reform in 2009 are still high, despite Senator Daschle’s withdrawal and the worsening economy.  In fact, the economic crisis has made the case for reform even more compelling.  Indeed, it is useful to remember that the health reform debate is far larger than any one man or woman and the underlying reasons for reform are unchanged. 

• Our health system is on a trajectory that cannot be sustained. The costs of inaction are high and they will only rise over time. Families, employers, and governments are all threatened by rising health care costs. These trends will not change on their own. In fact, they will worsen. This issue is not going away and neither are the "strange bedfellow" coalitions of business, labor and consumer groups that helped make health care a decisive issue in the 2008 campaign.
• Our struggling economy has revealed and worsened the flaws in our health system and the call for reform will grow more urgent as a result. More and more families are losing insurance along with their jobs and are finding themselves unable to afford essential health care services. Countless interviews and media reports have documented jobless families who view affording health care as one of their most immediate economic concerns. The economic crisis only further demonstrates the need for reform and will only heighten the public's awareness of our system's gaps.   It also raises the ante for Congress.  While partisan posturing will not end tomorrow, most members will not be able to do nothing and declare victory to the people this time.  Doing nothing on health care will be seen as a failure, much as failure to pass a stimulus package will be seen as irresponsible.
• Health reform remains a priority for the Obama Administration and for Congress. David Axelrod captured this best when reminding reporters last week that "this issue has great power of its own." President Obama has stated consistently that making insurance affordable for all Americans is a primary goal of his administration. This goal is shared by key Congressional leaders, including Senate Finance Chair Max Baucus, HELP Chair Ted Kennedy, Energy and Commerce Chair Henry Waxman, and Ways and Means Health Subcommittee Chair Pete Stark. Now that SCHIP is signed with the economic stimulus package soon to follow, the full attention of these key leaders will shift to comprehensive health reform.
• The American people, throughout the 2008 campaign and beyond, have called for a better, more affordable health system. The people who sent Barack Obama to the White House will not change their views on our health system because of Tom Daschle's withdrawal. They elected Obama to do a job, and what particular individual holds what particular job matters little in the grand scheme of the overwhelming desire for "real change."

As many of you know, I was a senior adviser at the Office of Management and Budget (OMB) during the Clinton-era reform efforts. Throughout the past week, I was compelled to recall what we were all doing in February 1993. At this moment (and many other moments) 16 years ago, we were going through an Ira Magaziner "toll gate" exercise with 500 of our closest friends. In large working groups, we were trying to write down a detailed blueprint of a new health care system that did not exist in nature.

Look where we are now. This time, the chairs of Finance and HELP have pledged to work together to build upon our existing system, while making it work better for all. We also have a president who understands that the lessons of 1993-4 require (among other things) an unshakable commitment to bipartisan conversation. (And yes, health reform must and can still be bipartisan).

Further, many more stakeholders, like our own group Health CEOs for Health Reform, and countless other employers and labor leaders are willing to say, "The status quo is unsustainable and we CAN work collectively to align interests and reform our system to serve everyone."

We should not lose sight of how much further along the health reform debate is today compared to the winter of 1993. Congressional leaders have emerged; bipartisan conversations have been initiated; and, industry leaders have shown some signs that they are willing to engage, rather than obstruct. The moral and economic motivations for this issue are too strong, the costs of failure too high, and the progress towards our goal too great for our optimism to wane. Now remains the time to act.