By Malorye Allison, ReformPlans.com
Fri. Sept. 26, 2008
A growing number of experts have abandoned all hopes of major health reform. “The bailout makes it that much tougher, because health care will be crowded out by other issues,” said Drew Altman, president and CEO of Kaiser Family Foundation yesterday. Altman was speaking at a press conference where he and colleagues were unveiling Kaiser’s 2008 Employer Health Benefits Survey data.
That data was unnerving enough: The cost of insurance keeps rising, including out-of-pocket expenses, much faster than wages. But the news about health reform was even more sobering. “Health care has to compete with other causes for money, which will be even harder to find now,” Altman said.
Health care policy pundit Bob Laszewski concurs. On Tuesday, Sept. 23, Laszewski’s blog post was entitled “The Chance for Major Health Care Reform in 2009 or 2010 is Now Zero.”
Laszewski pointed to the additional $1 trillion or so in Wall Street debt the U.S. government has had to take on in the last few weeks. On top of the already swollen $500 million budget deficit, that changed a lot of things.
Obama’s plan, Laszewski says, is a “non-starter” because it costs about $100 billion a year. The Catch-22 in health care is that the more people you get covered, the more health care services people use. Then, costs go up and it’s even more expensive to cover anyone else. Just ask Vermont, Main, or Massachusetts about that problem.
McCain’s plan, meanwhile, is unlikely to go forward because “deregulation” is now a dirty word, and that’s what McCain’s plan aims to do with the health insurance industry.
So, toss out any remaining delusions that either Obama or McCain will implement their health reform plan if elected. Those plans were on shaky ground to begin with. Now, they’ve been buried.
But as Altman points out, all hope is not lost. “This takes elected official off the hook [for big reforms] and gives the forces of incremental change more leverage,” he says.
What is imaginable, as I pointed out last week, is a set of smaller, stepwise reforms. With an Obama win, it wouldn’t take much for SCHIP to be expanded, for example, and some elements of Medicare to be tinkered with. Likely, for one, the agency would begin negotiating on drug prices. With McCain, meanwhile, there could be some expansion of HSAs and there would likely be legislation offered around tax credits and health premiums. But it’s hard to predict how far any of that would go.
These individual reforms will have much less public backing, as its much more difficult to get people excited about them and the ramifications are complex. “Insure everyone” or “leave the system alone” are much simpler slogans to campaign by.
I’m very interested in what you think the individual reforms that get proposed in 2009 could be. Write to me or post your feedback.
Note: Here’s the link to that post by Laszewski.
|
ReformPlans Blog 
