Expect More Health Reform Next Year

Posted by Kenneth Thorpe, Ph.D.

I recently presented some thoughts on health reform at an APCO-sponsored lunch and discussion. The event got me thinking: where is this debate headed? There is no simple answer. But the one certainty is that regardless of whether Democrats send a bill to President Obama’s desk this year, there must be more health reforms in the very near future.

Next year’s top agenda item will be deficit reduction. And any debate about deficit reduction must address entitlement reform, including Medicare payment reform, delivery reform, care coordination and chronic-disease management – all of which would save money and cut the deficit. These reforms would also improve the quality of care for millions of Medicare beneficiaries.

These important issues are not going to disappear if comprehensive health reform fails. And even if reform passes, there will still be much work to do as the current proposals only begin to scratch the surface of what needs to be done on these particular issues. So regardless of whether Democrats win or lose on health reform this year, there is no doubt health reform will continue. It will simply take a new form, be presented in a new format, and be framed in terms of cost – not access.

As far as passing a health reform bill this year, I do remain hopeful. There are important policies in the President’s bill that are supported by both Republicans and Democrats. For example, the most recent legislation would improve workplace wellness, build healthy communities, advance science-based nutrition and prevention education, fund community-based primary prevention, and increase preventive services to Medicare and Medicaid beneficiaries. These are policies that can make a real difference to Americans, and policy-makers should move forward with them.

However, if the recent White House “fix” doesn’t work, then we’re probably finished considering health reform for the remainder of the year. Starting from scratch is not appealing to congressional committee leaders (let alone their staff!), and the current political environment is not conducive to it as moderate Democrats may face tough reelection campaigns.

But that doesn’t mean health reform is over. It will be revisited next year in the context of deficit reduction. Of that I’m certain.