SOTU Light on Healthcare, Industry Reacts

In either a calculated dodge or a missed opportunity, President Obama's 2012 State of the Union address was light on references to healthcare reform.

If you watched the annual State of the Union address Tuesday night to hear President Obama talk about his healthcare accomplishments and what he plans to do next then you came away disappointed. Ditto if you thought he might make the case for the individual mandate while he had five of the Supreme Court justices sitting in the room.

The president was almost three-quarters of the way through his speech before he made this quick statement: "I will not go back to the days when health insurance companies had unchecked power to cancel your policy, deny you coverage, or charge women differently from men." You'd have to be a good listener and something of a healthcare/political junkie to recognize that reference to the Affordable Care Act.

About 1,300 words later the president linked in a single paragraph Abraham Lincoln, small government and a quick mention of the healthcare reform's reliance on "a reformed private market, not a Government program."

Oh, and there was this pro forma comment about controlling entitlement program costs: "I'm prepared to make more reforms that rein in the long-term costs of Medicare and Medicaid, and strengthen Social Security, so long as those programs remain a guarantee of security for seniors."

As a reporter I am inundated with government information about how the ACA is reducing healthcare costs. None of that made it into the president's speech. What gives?

Off the record, one source suggested that healthcare reform just doesn't resonate with the public. "The bad economy affects almost everyone; the lack of health insurance not so much."

Stakeholders and policy analysts, who are usually chomping at the bit to comment on speeches, rules, regulations, etc., have been more or less silenced by what one group described as the "dearth of references to health reform or healthcare policies" in the speech.

I did collect some comments about what was said or not said about healthcare in the State of the Union address. Here is a sample of perspectives on the speech:

Paul Keckley, Ph.D., executive director Deloitte Center for Health Solutions
"During his State of the Union, the President chose not to connect the dots important to the public debate about health reform. Since the downturn, the healthcare industry added 1 million jobs while the rest of the economy dropped 7 million. Health spending increases over the past 2 years—3.8% and 3.9%—were the lowest in decades."

"The healthcare industry is facing growing demand by being innovative, efficient and responsive to its challenge to provide better value to consumers. With or without the Affordable Care Act, it will continue its transformative journey from patients to consumers, volume-based incentives to value, and fragmentation to connectivity and coordination."

Ethan Rome, executive director of Health Care for America Now, a grassroots healthcare advocacy group
"President Obama laid out a clear, sensible vision to restore the health of America's economy, create jobs and address the income inequality that is weakening our nation. America needs to rally around this plan. Indiana Gov. Mitch Daniels, who took a break from his campaign to silence workers' voices on the job, …can't hide the record."

"The Republicans have opposed making healthcare affordable, they've blocked every effort to create jobs, they've been trying to undermine the laws that hold banks accountable and they've rejected every step needed to revitalize the U.S. economy…President Obama outlined concrete plans to give everyone a fair shot at achieving the American Dream."

Chip Kahn, CEO of the Federation of American Hospitals.
"Healthcare reform was totally absent from the speech. He used the speech to develop the equality issue, which will be the theme of his re-election campaign. I think that means that in this election year we're going to see stealth healthcare reform from the Democrats. They'll try to unbridle Republicans from the seniors on the Medicare issue. Republicans will try to talk about the Medicare and the deficit. Everyone will be talking past each other."

David Kendall, Senior Fellow for Health and Fiscal Policy, Third Way
"The President made healthcare cost control a permanent part of his agenda. He wants to go beyond healthcare reform and achieve additional savings in Medicare and Medicaid. Washington now has a once-in-a-generation opportunity to align the federal interest in controlling costs with efforts already underway in the private sector to make healthcare affordable in the long run."

Mark Parkinson, president and CEO of the American Health Care Association and the National Center for Assisted Living
"Our profession has made great strides, yet we are struggling to meet growing demand in the light of diminishing federal and state funding. We have improved in quality. Many of our facilities are hiring doctors and reducing hospital readmissions. We have improved in delivering a variety of health care options for seniors. That significant progress could all be put at risk if policymakers continue to avoid serious discussions centering on how we are reimbursed."

Curtis Rooney, president of the Healthcare Supply Chain Association (HSCA).
"HSCA and the group purchasing industry applaud Pres. Obama for his commitment to preserving the Medicare and Medicaid programs while also reducing costs across the healthcare system…Hospitals face mounting financial pressures, and continued implementation of federal healthcare reform will likely increase the strain."

Cyndy Nayer, President/CEO Center for Health Value Innovation
"Mr. Obama's references to health care were spot on for his agenda. He said he was not going back, and, in many ways, the country cannot go back:  health information technologies are being rapidly deployed, 26 states have exchanges in process, and the system has ingested the rules for improved prevention and wellness strategies." 

"Can the Congress, or the Courts, pull back the individual mandate? Of course, but that will not change the focus on wellness and prevention including the better management of chronic care. The bigger point may be the incredible focus he made on job creation and keeping private insurance in the 'game.' The big message of building a healthier, prosperous U.S. cannot be missed:  health and business improvement are intrinsically tied, as we know."