Health Care Policy and Marketplace Review: Health Care Reform Will Be a Long Shot in 2009
Thursday, April 24, 2008
Health Care Reform Will Be a Long Shot in 2009
Many people, me included, have compared the recent resurgence in calls for
health care reform with the big debate we had in 1993 and 1994 and the expectation back then that we would see
major health care reform. Of course, all of that focus on the issue ended with the
failed Clinton Health Care Plan derailing
health reform for at least 15 years--and counting.
Each of the remaining
candidates for president--Clinton, Obama, and McCain--have major health reform proposals.
Health care continues to register as
one of the major issues voters want addressed and expectations are rising again.
But the chance for major health care reform in 2009--or 2010--is a long shot.
The problem is that the country is divided right down the middle on which very different direction to go on the issue. As high as
health insurance costs are and as dissatisfied as consumers are with the system there is no consensus on what should change and no real willingness for any of the major stakeholders to compromise.
I don't know who will be elected president in November. But I am confident that whoever it is the vote will be another very close election with about half of the people on one side and half on the other. While the
Congress will probably continue to be
Democrat controlled, there will be no big majority wanting to take the country in one
health care reform direction over another.
Something as big as
health care reform requires a clear consensus--among
voters and therefore in the
Congress. We have nothing close to that today irrespective of the apparently
strong commitment to health care change among the candidates for even incremental health care reform.
Jay Rockefeller is a
Senate Democrat that has been working on
health care reform for 20 years and he's an
Obama supporter. About the
$100 billion both Democratic candidates want to spend on health reform he says, "We all know there is not enough money to do all this stuff. What they are doing is...laying out their ambitions."
No one is a bigger supporter of
Hillary Clinton than fellow New York Senator
Chuck Schumer. He doesn't see any consensus on how to get health reform done either saying he's "not sure we have the big plan on
health care." He goes on, "
Health care I feel strongly about, but I'm not sure we're ready for a
major national health care plan."
The next
Congress, and likely the new President, will be ready to deal with a
permanent extension and expansion of the State Children's Health Insurance Program (SCHIP) and they will be forced to make some necessary decisions about how
Medicare pays physicians and
potential cuts to private Medicare plans to pay for them. But the
$100 billion expansion of health care Obama and Clinton want, or the
abandonment of the longtime employer tax exemption and new emphasis on the individual market that
McCain wants, are way beyond any kind of consensus we have among
voters and in the
Congress.
As bad as things are, they aren't bad enough.
Detailed analysis each of the candidates health care reform plans:
[COLOR=#445566]An Analysis of Senator Hillary Clinton's Health Plan Proposal[/COLOR]
[COLOR=#445566]An Analysis of Senator John McCain's Health Care Reform Plan[/COLOR]
[COLOR=#445566]A Detailed Analysis of Barack Obama's Health Care Reform Plan[/COLOR]