Health Reform

You often hear that everyone in America gets good health care, even if they are uninsured. Sadly that's not the case. As we noted in a recent policy brief, uninsured people get diagnosed later, die sooner, and the costs get shifted to the rest of us anyway.

Michael Tanner of the Cato Institute pointed out that health care costs are out control and spending, projected to rise from about 17 to 20 percent of GDP in less than a decade, is unsustainable. We agree. No health reform proposal will be sustainable without serious efforts to reduce costs and improve quality.

Iowa this week took a big bipartisan step toward covering uninsured low-income kids, but without yet settling the question of how to pay for it. The Bush Administration last year vetoed bipartisan legislation aimed at expanding SCHIP (the State Children's Health Insurance Program) and issued regulations that make it harder for states to broaden SCHIP eligibility on their own.

Determined to have a constructive voice in the growing national dialogue on health reform, the National Federation of Independent Business (NFIB), the nation's largest small business association, launched its new health care campaign—Solutions Start Here: When Healthcare is Fixed for Small Business its Fixed for America.

It's no surprise that the economy was the top issue for Mississippi voters in Tuesday's Democratic primary, but health care still resonated. Just over half the voters surveyed by network exit polls cited the economy as their top concern. But one in five said health care was their number one issue -- the same number as the Iraq war. (We would argue that health cost and coverage can be a component of economic anxiety as well).

The Mayo Clinic held a health reform conference this week -- New America's Health Policy director Len Nichols was there and he'll post about it momentarily. But Mayo also released a survey about what the public is thinking about health care. The Health Blog at the Wall Street Journal summed it up, but here are a few interesting snippets:

We read Senator Tom Coburn's (R-OK) piece in the New York Sun yesterday. While we applaud Senator Coburn’s commitment to reforming our struggling health system and his bill, S.

We flew in a bunch of survivors from the California health wars the other day to share their perspective with Washington policymakers gearing up for possible national health reform next year. As we all know, a carefully crafted bipartisan compromise between the Republican Gov. Arnold Schwarzenegger and the Democratic Assembly passed that chamber by a healthy 46-31 margin last December only to fizzle a month later in the state Senate Health Committee. The seven to one "no" vote was the legislative equivalent of blunt trauma to the head. Yet we were struck by the optimistic tone of our panelists. They built powerful coalitions against difficult odds around an ambitious hybrid public-private health coverage plan. Their ability to bring stakeholders together was an important lesson as we try to prepare bipartisan, cross-sector ground for national reform next year. And instead of retreating to lick their wounds, they are thinking about how to keep cooperating in the future. One possible target: the much-publicized "rescissions" in which insurers have retroactively cancelled policies after an insured person gets sick and starts costing them money.

The Kettering Foundation, along with Public Agenda and the National Issues Forum Institute, held what they billed as a novel experiment in public thinking about health care and the environment this week. We attended the health care event -- a half-hour film of focus groups around the country of ordinary people talking about the trade-offs of health reform, followed by a panel discussion by nine experts in public opinion or public policy (but not necessarily in health policy). They plan on holding more discussions across the country in the coming months.

We certainly laud dialogue on health care -- particularly recognition upfront that it involves tough choices and tradeoffs. One of the pitfalls of previous reform efforts, we think, is that people were asked if they wanted to improve the system but not immediately confronted with all the implications of that choice -- and then they backed off in a panic.

We just spent two days at AHIP’s (America’s Health Insurance Plans) 2008 National Policy Forum, an annual gathering about the challenges facing the industry. Despite the multitude of speakers with markedly different world views, the similarity of the themes was remarkable – and telling. We may have finally reached a point in the health care conversation where we are forced to agree on the fundamentals. Hallelujah.

The common refrains from the choir: