On the Road to Reform?

Les Masterson, for HealthLeaders Media, July 9, 2008

The last time the nation's capital was abuzz with major healthcare reform talk the initiative came from the White House. This time around, Capitol Hill is already leading the charge—even before the new president takes office in January. Senator Edward M. Kennedy (D-MA) has been hosting meetings with a wide variety of healthcare specialists as he gets ready to present a new universal healthcare proposal in the fall.

Kennedy, who is undergoing treatment for brain cancer, is hoping to build a bipartisan coalition in support of a major initiative and possibly add major healthcare reform to his legacy. According to The Boston Globe, Kennedy has been meeting with leaders from both parties, as well as business and labor, providers and insurers.

Though Kennedy is getting the headlines, he is not the only one eyeing healthcare legislation. A bipartisan effort to make private insurance accessible to all Americans is also on the table. And that doesn't even count the numerous bills in state legislatures, most notably California.

This is not Kennedy's first foray into healthcare legislation. The senior senator backed the Massachusetts healthcare reform plan in 2006, helping gain federal funds to subsidize the program.

That program has been a mixed bag. Costs have exceeded the state's expectations, partly because more people than expected (most notably the elderly) have signed up for the state's subsidized program. There have also been concerns raised that there aren't enough primary care physicians to care for the influx of the newly insured.

Policy and health leaders from throughout the country have been monitoring each rise and plunge on the Massachusetts health reform rollercoaster, but it's doubtful that any federal healthcare legislation would mirror The Bay State's individual mandate—a controversial, but critical, component of the program.

Having the Kennedy name attached to federal legislation could be just what major healthcare reform needs—especially given the senator's serious health concerns. After the assassination of President John F. Kennedy, his successor, Lyndon Johnson, used the legacy of the fallen president to win support for his Great Society legislation—most notably, the Civil Rights Act of 1964.

That same momentum is there for healthcare reform now, and the next president will put healthcare at the top of his domestic agenda.

Liz Boehm, principal analyst at Forrester Research in Cambridge, MA, says the ultimate reform will depend on who wins the presidency and the level of collaboration between Capitol Hill and the White House.

"It's just the question of the degree and the approach, and then it's a question of how much agreement can you create between the legislative and executive," says Boehm.

No matter which reforms are implemented, Boehm says, the process will take time given the complications and fundamental problems in the healthcare system.

"I am hopeful that something will happen in the first term of the new president, but my expectation is it will be a lot harder than it looks," says Boehm.

The fact that Kennedy has included health insurers as part of the discussion and that the Massachusetts reform incorporates health insurance as a key cog to its success are two positives for the health insurance industry. Whether meaningful healthcare reform can happen at the federal level is questionable, but through this broad coalition Kennedy has at least started a healthy discussion.

Les Masterson is senior editor of Health Plan Insider. He can be reached at lmasterson@healthleadersmedia.com .
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