Monday, June 1, 2009

A cicada moment? - April 23, 2009 column

President Barack Obama and Democratic congressional leaders agree that health care reform is overdue and should pass this summer. Or this could be another cicada moment.

The cynical view in Washington is that health care reform is like the cicada.
It comes around every 17 years, makes a lot of noise and then disappears.

Ron Pollack, head of Families USA, a health-consumer advocacy group, offered the cicada analogy at a news conference. But while he and others are hopeful, health care reform is not a done deal.

Conservatives are arrayed against reform, which they see as socialistic and over-reaching government. Some liberals are wary that key provisions will be dropped as part of a compromise. And there’s talk the Democrats could try to use a budgeting procedure known as reconciliation to push the measure through without Republican support.

How much really has changed since Harry and Louise scared people off Bill and Hillary’s universal health care proposal in 1993? Thirty-seven million people lacked health insurance when a TV ad paid for by the Health Insurance Association of America galvanized people against the Clinton brand of reform.

In the ad, Harry and Louise are sitting at their kitchen table, worried about the bureaucracy and lack of choices in the Clinton plan. The ad hit a nerve, and people in droves wrote and called their congressmen, urging them to vote no on “HillaryCare.”

Once again, a popular president promises reform. There’s a consensus that American business can’t compete in a global economy with escalating health care costs. But, while the Clinton plan was conceived in secrecy, Sen. Max Baucus, chairman of the Finance committee, has held more than 20 public hearings.

Sen. Edward Kennedy, chairman of the Health, Education, Labor and Pensions committee, has returned to Washington battling brain cancer to meet with various groups.

Baucus and Kennedy wrote Obama Monday, saying they planned to have very similar bills ready in June. Three House committees are working through legislation and could have a bill on the House floor by August.

Meanwhile, the ranks of the uninsured have grown to 43 million. Health care consumes 17 percent of GDP, and health care costs are escalating.

Harry and Louise have changed their tune. The couple made a comeback in a TV ad during last year’s Democratic and Republican national conventions.

This time, Harry and Louise agree the next president should put health care at the top of his agenda. Five diverse groups sponsored the ad -- the National Federation of Independent Business, Families USA, American Hospital Association, American Cancer Society Cancer Action Network and the Catholic Health Association.

Obama convened a health care summit soon after he took office, and a team of White House officials is working with Congress to get a bill passed. He put a $634 billion down payment on reform in his budget. But the ailing economy and heavy stimulus spending have dominated his and the nation’s attention.

One sticking point is the public plan. Obama promised an option for people to buy into the same health insurance coverage members of Congress have. Those who want to stick with their private insurance plans could also do so.
Some analysts say millions would flock to a public plan, which could hurt private insurers.

Much depends on how Obama brands his reform and whether critics get to it first. Congress passed Medicare and Medicaid in 1965 after Lyndon Johnson’s triumphant 1964 presidential campaign in which health care for the elderly was a priority. The public inundated Congress with cards and calls asking for Medicare.

The government already picks up the tab for nearly half the nation’s health care. Public plans cover the poor, working poor and their families, the elderly, disabled and the military. One simple way to expand coverage is by extending Medicare to cover other age groups.

The incremental approach works. Public health plans cover about one in five Americans under 65. The government covers about 35 percent of children. Obama signed an expansion of the Child Health Initiative Program, and he helped lower costs for the unemployed to purchase health insurance.

But most people under 65 have private insurance. If Obama can persuade these Harrys and Louises to tell their senators and congressmen to embrace change, health care reform could happen soon.

-- Marsha Mercer
(c) 2009 Marsha Mercer. All rights reserved.

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