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Factors Could Promote, Prevent Health Care Reform

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Many health policy analysts "disagree over whether health reform will succeed, and whether it should be" President-elect Barack Obama's "first priority," particularly "amid a sinking economy," USA Today reports. According to USA Today, "for significant change to occur, health care must stay a priority for his administration and for Congress," and "[s]pecial interest groups whose conflicts helped derail change in 1994 must come together."

USA Today reports that there are "signs that may happen," as the National Federation of Independent Business and other conservative business groups have partnered with the Service Employees International Union and Families USA to urge the Obama administration to move on health reform within its first 100 days. HHS Secretary-designate and former Senate Majority Leader Tom Daschle (D-S.D.) also will head a new White House Office on Health Reform. In addition, hospital, physician and consumer advocacy groups are holding discussions with staff for congressional leaders on health care reform, including Senate Health, Education, Labor and Pensions Committee Chair Edward Kennedy (D-Mass.), "a longtime champion of overhauling health care," USA Today reports.

The health insurance industry -- which "helped turn public opinion against the last attempted overhaul" through its "Harry and Louise" advertisements -- also has said it wants change, according to USA Today. Robert Zirkelbach, a spokesperson for America's Health Insurance Plans, said, "Now is the time," adding, "Fifteen years ago, we simply responded to other people's proposals. This time around, our board felt we had responsibility to come up with solutions and proposals."

According to USA Today, several factors indicate that "health reform might happen." Paul Ginsburg, an economist with the Center for Studying Health System Change, said that the economic recession means more people will be losing their jobs and employer-sponsored health insurance. At the same time, states are scaling back on Medicaid programs for low-income residents. Some lawmakers say that health reform must be part of an economic fix because it represents 16% of the U.S. economy.

In addition, Kennedy, "one of Congress' most prolific legislators," has made health care his top priority, USA Today reports. Kennedy, who was diagnosed with a malignant brain tumor, has bipartisan support for his health care plan, and lawmakers could vote for the plan as a way to secure the senator's legacy, according to Michael Cannon of the Cato Institute.

Lawmakers also have learned from past efforts to overhaul health care. Kaiser Family Foundation President and CEO Drew Altman said, "There is a leadership effort in the Senate to create a legislative vehicle that can bring everyone on board."

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Factors That Could Prevent Reform

USA Today also reports that several factors could prevent lawmakers from enacting health reform. The incoming Obama administration and Congress will have to deal with other important issues, including the economy and the wars in Afghanistan and Iraq. Cost also will be an issue, as Obama's health care plan is projected to cost nearly $1.2 trillion from 2010 to 2019, according to an analysis by the Lewin Group. Congress already has allocated $700 billion to the Wall Street financial bailout, and the U.S. budget deficit is expected to reach nearly $1 trillion, Joe Antos of the American Enterprise Institute said.

A lack of consensus on the provisions of a health reform bill also could prevent action. Altman said, "In recent times, the major reason there's been no action in Washington is the Grand Canyon-wide difference on how to reform health care" between special interest groups, lawmakers and the general public. Health policy consultant Robert Laszewski said, "There is no consensus in Congress or the country on what a comprehensive health care bill would look like," adding, "Plus we don't have the money." Harvard University professor Robert Blendon also said, "A consensus bill between the majority of both parties would be very hard to get" (Appleby, USA Today, 12/19).


In related news, House Energy and Commerce Committee Chair John Dingell (D-Mich.) has decided not to seek the chair of the panel's Health Subcommittee so that he can focus on legislation that would overhaul the U.S. health care system, Roll Call reports. As part of an agreement with incoming Committee Chair Henry Waxman (D-Calif.), Dingell will assume a leading role in crafting comprehensive health care reform legislation and serve as its main sponsor and lead negotiator with the Senate and the Obama administration. Dingell also will assume ex-officio status on all Energy and Commerce subcommittees, which will allow him to decide whether to participate in hearings and will give him access to an undetermined number of subcommittee staffers, Roll Call reports.

In a statement, Waxman said that Dingell's "great talent, experience, and political skill will be a tremendous help to me and an asset to the Committee as we move forward on important legislation," adding, "Working together I expect that we will embrace the new opportunities facing us and work with the Obama administration to deliver the change that our country needs" (Newmyer, Roll Call, 12/18).

Reprinted with permission from kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, and sign up for email delivery at kaisernetwork.org/email . The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation. © 2007 Advisory Board Company and Kaiser Family Foundation. All rights reserved.