With Obama win, health reform on the horizon

by Lesley Politi on November 6, 2008

With Obama win, health reform on the horizon

Now will come another great national debate about reforming our nation’s health care system.

President-elect Barack Obama has said this is a priority. His party controls both houses of Congress. If ever the forces to change health care were aligned, it would seem to be now.

Look for Obama to try to make good on his promise to expand coverage to all children, first and foremost. Beyond that, look for proposals that will alter the way health insurers operate.

Obama has said he favors regulations that would require insurance companies to accept all applicants, regardless of how sick they might be. Also, he wants to limit how much premiums can vary based on a person’s health status. Both moves will be  controversial.

Another fight will surround Obama’s proposal to ask all but the smallest employers to provide health insurance to their employees or pay into a fund. This policy, known as “pay or play,” will almost surely evoke resistance from segments of the business community.

Obama hasn’t yet indicated how much he’d ask businesses to contribute if they don’t supply health care coverage to their workers. Keep on eye on this number: It will be an important signal. Massachusetts, which has implemented a similar policy, kept fines for employers low to avoid alienating businesses.

Health economists warn that expanding access to health insurance to all Americans – a goal Obama has said he embraces, in principle – won’t be feasible, financially, without significant steps to control escalating health care costs. Obama has indicated he takes cost control seriously, and will take steps to create efficiencies in how care is delivered, particularly to people with costly, chronic illnesses. But this is a Herculean task.

As people across the country lose jobs in this troubled economy, it will be interesting to see what moves Obama’s administration takes, if any, to make sure they continue to have coverage while trying to transition back to work.  Similarly, broadening public programs such as Medicaid — another plank of Obama’s health care plan — won’t be easy, given mounting financial stress nationally and in the states.

Most important of all will be the vision that Obama articulates as he presses for health reform. This will set the groundwork for all that follows. Without a clearly articulated, compelling vision that calls for substantial changes in America’s health care system, the enormously powerful, entrenched interests that dominate the status quo will prevail.

This is where Obama has the chance to make a significant and potentially lasting mark.  The problems with health care are well known.  Americans are increasingly fed up and worried about this aspect of their lives.   What’s been missing is the will to take on this complex issue and an ability to chart a path forward. 


Source: www.chicagotribrune.com

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