Health Reform in 2009: Are you Ready?

Several weeks ago Sen. Max Baucus, D-Mont., chairman of the Senate Finance Committee, released a much-discussed position paper on health reform in 2009.
It outlines, in 104 pages, the problems of our current health system – high cost, low quality and 46 million uninsured. It also presents a plan for action, which is, without getting into details, one that resembles President-elect Barack Obama’s proposal more than it does Sen. John McCain’s.

The Senate Finance Committee is powerful, and the chairman sets the agenda. The position paper and accompanying press conference states, in effect, that Baucus intends to make health care one of the committee’s issues come next year.

Not only that, but Sen. Ted Kennedy, D-Mass., a looming presence in the Senate, chair of the Senate Health, Education, and Labor Committee and a longtime public advocate for health reform, is doing his part to frame the debate from a different perspective and angle than Baucus.

Two powerful senators committed to reform?

In the midst of an economic crisis, many thought health reform, which has already proven an exceedingly difficult task, with firmly entrenched interests – providers, insurers, big pharm and idealogues on both sides of the aisle – was unwilling to capitulate. And a present ‘system’ that is probably more aptly characterized a jigsaw puzzle or maze of red tape would be completely off the agenda when Congress reconvenes in Washington post-Jan 20.

Beyond its content, the position paper’s release, which strikes a bipartisan tone, shows insight and symbolically indicates that health reform is sound economic policy. Former CBO Director and new Office of Management and Budget director Peter Orszag has referred to health care costs repeatedly as the central long-term fiscal challenge facing this country, despite what newspaper headlines might trumpet (or not).

In fact, President-elect Obama’s naming of Orszag, a director known for his obsession with health care, as the new chief of the OMB is another indication that health reform will have another strong and well-positioned advocate in the new administration.

But what health reform will actually look like is anyone’s guess.

My take, as vague as it might be: The solution will be uniquely American, as distant from single-payer apocalypse (according to the right) as from sentencing the poor to a life of chronic illness and premature death (according to the left).

The Baucus position paper shows an intense awareness of the variety of voices necessary to make the health system effective and low-cost. For certain problems – covering the uninsured – public solutions might be better. And for others – decreasing cost and improving quality – private or public-private hybrid solutions might be better.

Big players in Washington are assembling to work together on this issue, and the apparent desire to compromise and cooperate to reform health care, convinces me that health reform isn’t going anywhere.