There has been much speculation that the (great) distress in the economy means that major health care reform is unlikely in the coming years. In addition, with health care representing over $2 trillion in the economy - that means there are $2 trillion reasons some interest or other will resist change. While crystal balls are always fuzzy, when I look at the magic eight ball - “all signs point to yes.” What follow are my nine reasons why health reform will happen in 2009 (with thanks and credit to Chris Jennings of Jennings and Associates).
1. Health care IS a core economic issue. Rather than seeing the major economic problems as reasons not to address health care, there are good reasons to see this are a reason TO address health care — and this is being reinforced by leading economists such as Henry Paulsen, Ben Bernanke and incoming economist heavy weights in the new administration such as Peter Orszag (who will take over the Office of Management and Budget) and Tim Geithner (incoming Treasury Secretary).
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The dust is quickly settling on the collapsed nomination of Tom Daschle to head both HHS and the White House Office of Health Reform. Apart from the pervasive chatter about Daschle’s problematic tax and business dealings, and about the President’s appointments process - what does Daschle’s departure mean for those of us focused on improving the health care system?
Let’s keep our eyes on the prize – transforming an inefficient and ineffectual health care enterprise into a dynamic, responsive, and effective one. Tom Daschle’s insights really did make him well-suited to the leadership role. We should do well to keep these at the forefront in forging ahead to address health care’s shortfalls.
First, Daschle understood the nature of the interlocking drivers that maintain our system as-is. His book, Critical, underscores that there are many forces that shape our health care and these same forces — aka “special interests” — reinforce and perpetuate each other. There’s not one glaring culprit to point the finger at.
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This is an article by Atul Gawande from the recent New Yorker in which he makes the case for major reform building on existing structures. He not only provides good examples of how other countries have evolved their health care systems, he provides a good framing and analysis of what needs to happen here in the US. In particular – two excerpts capture his message (and capture well PBGH’s effort to foster transformational change building on what we have):
“[A]ccepting the path-dependent nature of our health care system – recognizing that we had better build on what we’ve got – doesn’t mean that we have to curtail our ambitions. The overarching goal of health-care reform is to establish a system that has three basic attributes. It should leave no one uncovered – medical debt must disappear as a cause of personal bankruptcy in America. It should no longer be an economic catastrophe for employers. And it should hold doctors, nurses, hospitals, drug and device companies, and insurers collectively responsible for making care better, safer and less costly”.
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