Katie Connolly
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May 11, 2009 03:17 PM
Today saw a meeting at the White House that healthcare reform advocates in the 1990s could only have dreamed about. The President stood alongside representatives of health insurers, unions, pharma, doctors and hospitals to announce this unlikely coalition has pledged to reduce the growth of health care costs by 1.5 percentage points each year between 2010 and 2019. The White House estimates that this will cut spending by over $2 trillion dollars. POTUS outlined the circumstances that forged this unprecedented alliance:
"What's brought us all together today is a recognition that we can't continue down the same dangerous road we've been traveling for so many years; that costs are out of control; and that reform is not a luxury that can be postponed, but a necessity that cannot wait. It's a recognition that the fictional television couple, Harry and Louise, who became the iconic faces of those who opposed health care reform in the '90s, desperately need health care reform in 2009. And so does America."
This is surely an excellent signal that healthcare reform is not only possible but likely this year. It sends a message to Congress that the President is serious about spending some political capital in order to get this done amid multiple other crises, and that the likelihood of a united front of stakeholders stonewalling reform entirely is low. Previous opponents of reform are clearly now eager to be part of an effort at shaping it. (Read my profile of Chip Kahn, the guy who thought up Harry and Louise in the 90s but supports reform now here.) But don't start counting chickens just yet. The announcement today was awfully vague about the mechanisms that will be used to lower costs. That's symptomatic of almost all aspects of health reform: It's when policymakers start putting flesh on the bones of a healthcare plan that the fireworks start. Getting agreement on broad principles of reform - like lowering costs, expanding coverage and encouraging preventive care - is the easy part. Figuring out how exactly to do that is where the wheels can fall off.
The President is off to a good start. With the White House Forum on Health Care earlier this year and today's meetings, he's gotten stakeholders to publicly commit to reform and start conversations with each other about it. It might just be the most promising news on healthcare for decades. But it's possible that the villains of the 1990s - especially the insurers - want to be part of the President's gang because they know reform is coming and they'd rather be, as the Cato Institute's Michael Cannon put it, at the table than on the menu. At this stage, their participation doesn't signal that they'll actually support meaningful reform. It simply means they'll be able to lobby for their interests from inside the tent.
One reason for the insurers to be at the table is to argue against the idea of a public plan. Sure they want uninsured people to be covered, but they want to be the ones doing the covering not the government. Growing the number of people insured means more premium income for insurers. A public plan would not only limit their access to this new revenue stream, but it would likely attract many of their members aswell, jeopardzing profits and forcing a realignment of premiums. So while today's developments are certianly positive for reform advocates, the fun and games have barely begun.
