Summary
The Health Reform Office in the White House, as this article states, spearheads a commitment at the highest level to act in the health policy arena. It is not all about the rights of Americans to a civil, human, or economic right to health. The reason to act is because our economy cannot afford for us not to act. The article also emphasizes that OMB is a key player in this debate with planned savings in the macro health cost equation already banked on in area's where health interventions are not linked to improved outcomes.
Analysis
The health reform on the horizon can take many forms, but it can only be justified politically by pooling together funds that are already being spent on health care. For example, when President Obama speaks of wrapping entitlement reform of Medicare and Medicaid in with health reform, the projected savings from entitlement reform will help pay for any health reform that garners support from a major coalition within Congress. Keep in mind that President Carter's health reform was scaled back to a hospital cost containment proposal due to political winds. The third big bang in American entitlement policy may not be on the horizon. But some form of reform probably is.
For now, industry is most affected by the political willingness to institute a public plan option for comprehensive coverage. The model of a system for full coverage that does not offer a publicly sponsored plan is the recent Medicare prescription drug plan offering. In this bargaining process, major concessions were made to PHARMA, and the same would probably happen in manor concessions to insurance and managed care companies if the same model were applied to comprehensive coverage. The spoiler, of course, is a public plan offering. Blue Dog Democrats are not yet in support of a public plan.
The big question is if later in the process, the Administration will support changes to Medicare and Medicaid as a way to pay for comprehensive coverage. Or moreso, what changes they will support. For certainly, as the article points out, OMB already has areas of "waste" in mind.
In the Clinton effort, existing Medicaid financing was projected towards reducing cost calculations for the Administration proposal. If they had not done this, the cost calculations would have been even higher. President Obama's approach is to take the "savings" from Medicare and Medicaid, new funds from the budget ($630 billion over 10 years), and other projected savings in the system to pay for the reform. So heed the care that is not linked to improved outcomes -- and who is providing it. This is probably where the Administration's proposed cuts will be.
