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Healthcare Reform's Not Over by a Long Shot

Philip Betbeze, for HealthLeaders Media, January 22, 2010

That sound you heard late Tuesday night coming from the Northeast was a great sigh of relief for the opponents of the Democrats' approach to healthcare reform.

You'd think from hearing from all the talking heads on the news channels over the past few days that healthcare reform as we think we know it (has anyone actually read all 2,000 pages in this bill?) is dead—thanks to the victory of Republican Scott Brown over Democrat Martha Coakley this past Tuesday in the race for the Massachusetts senate seat once held by uber-liberal Ted Kennedy.

So are they right?

I highly doubt it.

In reality, healthcare reform has likely been delayed, not defeated. That's because outside of the political shouting matches into which the healthcare reform debate has degenerated, we still have a huge problem. Maybe you don't agree with the way the Democrats, with their Congressional super-majority, have attempted to fix the long-term challenges surrounding cost, access, and quality for healthcare consumers.

I certainly have outlined my problems with their approach in this column over the past year or so. But I've also had the privilege over the past few days of talking with a number of smart, highly placed senior financial executives in hospitals and health systems. If they hated the bill, they aren't celebrating. If they loved the bill, they don't despair.

The bottom line is we still have a healthcare inflation rate that's at least three times the rate of inflation and at least three times the rate of wage growth in this country. That can't continue.

But the problem is so immense that it's like the argument over our ever-expanding national debt. None of the potential solutions are palatable. We can continue to slowly borrow our way into oblivion, or we can stop living on our collective credit and crater the economy. Perhaps there's a middle ground.

In the same way, we can continue to live in the fantasy world that the Medicare trust fund won't go bankrupt somewhere around 2018, or that commercial health insurance premiums won't rise so high in price as to put more and more people in the "uninsured" camp and make more and more companies unable to compete with those in other countries. Perhaps there's a middle ground there too. Meanwhile, ignoring or papering over problems with meaningless or harmful bills is an outcome at which Congress, as a group, seems best suited.

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