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Healthcare Reform's Not Over by a Long Shot

 |  By Philip Betbeze  
   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.

All of this frustrating back-and-forth while problems grow ultimately leads me to a positive outlook for meaningful healthcare reform—eventually. Perhaps Democrats will move toward a group of solutions that include good ideas from the other side of the aisle.

Here are some ideas for our representatives:

  1. After a year of debate, you should be familiar with most of the details of various proposals for healthcare reform, so you don't need help from lobbyists to craft the bills.

  2. Let's get companies out of the provision of healthcare

  3. Let's make sure people have incentives to purchase health insurance if they can afford it.

  4. Let's bring the marketplace to bear, where appropriate, on the cost of healthcare.

  5. Simpler is better.

  6. Vote on separate proposals for healthcare reform on their own merits (instead of loading everything into an omnibus bill that encourages pork and waste—the very thing our representatives claim to be trying to eliminate in healthcare reform).

When a momentous election loss like Coakley's happens and throws a wrench into what many of us thought was a done deal, it reminds me of what Winston Churchill said about Americans while Great Britain was the only bulwark against Nazi Germany and hoping for American intervention: "You can always count on Americans to do the right thing after they've tried everything else."

At the risk of sounding trite, here's why I'm optimistic about healthcare reform: We've already tried just about everything else.

Philip Betbeze is the senior leadership editor at HealthLeaders.

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