Everyone's talking about health reform after the elections. How do we get there?
Drew Altman, CEO of the Kaiser Family Foundation, outlines four steps to make it happen.
First, health care has to figure big in the November election. If Iraq, the economy or other issues eclipse health in the mind of voters, the odds of progress are diminished. (Yes health care and economic anxiety are related, but it's too soon to know how they will be linked in voters' minds come November )
Second, we'll need presidential leadership. For health reform to stand a chance "a new president will have to make it an early and top priority and exercise real leadership," Altman writes. The temptation might be to focus on unfinished business, such as the State Children's Health Insurance Program. That would be a step (or two or three) forward, but it isn't comprehensive national reform.
Third, we'll need compromise. Genuine, bipartisan, centrist, give-and-get compromise. "No matter who is in the White House or what the margins are in the Senate, it is very unlikely that the deep divisions about how to reform our health care system between left and right will have been transformed enough to support passage of legislation that will entirely satisfy either liberals or conservatives. Health care's ideological divide is too deep." A Democrat in the White House would mean tilting a bit leftward, and a Republican would mean going a bit rightward, but the center has to hold through the ideological fights as well as the clashes over financial winners and losers in a transformed $2 billion health care system.
Finally, from now through at least November, we've got to talk (not shout), educate, learn and listen. Our task is to "establish the facts and dispel myths." And for policymakers, that means not only listening to each other but to the public. What do ordinary people experience when they get sick? What do they worry about? How do they see health care costs and care tying into their growing economic anxieties? We'll have plenty of time to fight about the details next year. But let's do the groundwork now.
(Quick disclosure: I was a media fellow at the Kaiser Family Foundation last year.)