Brown's Senate Win Creates Health Reform Dilemma for Democrats

David C. Harlow, principal of The Harlow Group, LLC, a healthcare law and consulting firm in Newton, MA, says, "Is the pending health reform plan perfect? No. Better than the status quo? Probably. Will doing nothing ensure further cost and quality meltdown? Almost definitely. Will that meltdown lead to some form of public option down the road? Entirely possible."

Harlow says the election may be a referendum on health reform in Massachusetts, which created its own reform that was seen as the basis for much of the national proposal. Though the state's experience has shown "impressive coverage figures," Harlow says, reform has also brought about costs that are more difficult to support during a recession.

"What are the implications for health reform? While Brown's victory enables a GOP filibuster blocking a Senate vote, Democrats have at least two options: House adoption of the Senate bill or the informal reconciliation process. Leadership is already exploring both options. The better approach may be to go back to the drawing board—but only in the unlikely event that the GOP can act as a true partner," says Harlow.

Meanwhile, Joseph C. Kvedar, MD, director of the Center for Connected Health at Partners HealthCare System in Boston, says Massachusetts voters may have been "short-sighted" on Tuesday, but healthcare delivery reform is inevitable. "If Brown is good to his word and won't cast his vote for the health reform bill, it will be a short-term setback. However, all of the discussion, and all of the thinking, have propelled many in the industry to a place where they will be moving in the direction of care delivery reform because it seems inevitable. We won't be waiting for the federal government to get their interests lined up," says Kvedar.

Mario Motta, MD, president of the Massachusetts Medical Society (MMS), says his organization shares similar viewpoints with the new senator. Both supported the state's universal health program, believe all Americans deserve healthcare coverage, and they agree healthcare costs must come down.

"Physicians share these concerns. Affordable insurance, reducing costs, preserving access to care, liability reform, primary care services, and fixing the Medicare payment system for physicians are some of the major issues facing providers and patients. We look forward to working closely with Senator Brown, as we have with the entire Massachusetts Congressional delegation, to resolve the issues facing our nation's physicians and to improve healthcare access and quality for all patients in Massachusetts and the nation," says Motta.

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