Pretty good. I’d say better than 50:50; probably 60:40 or better that there will be major reform in the next Congress.
Here’s why.
Sen Ron Wyden’s (D OR) Healthy Americans Act has six D and six R Senate cosponsors, including Bob Bennett (R UT). There is broad bipartisan support for the bill, which mandates universal coverage.
WalMart and the SEIU back the bill.
The National Federation of Independent Businesses backs some form of ‘universal’ reform.
Both Democratic Presidential candidates back major reform.
Congress has been stung by criticism of its inability to get much done – and health care reform is something big that needs doing.
Many of the Fortune 500 back reform, including automakers, service companies, and manufacturers. And the unions that represent their workers do too.
This impressive array of supporters is opposed by…well, it must be opposed by some groups, companies, politicians, lobbies, but it is hard to find much in the way of opposition, at least using internet search engines. We can look to California to find out how and why their efforts to pass reform failed. A loose coalition, comprised of Republican legislators, Blue Cross of California [WellPoint], the state Chamber of Commerce, and the tobacco industry joined together to oppose the bill, and their efforts got a major push from legislators’ deep concerns about the cost of the initiative and the Golden State’s financial straits. A closely related issue is the concern by many that states, acting alone, cannot enact meaningful reform for the simple reason that 1/3 of all health care dollars are controlled (to a great extent) by the Feds, and if these dollars, and the care they pay for and members they cover aren’t integrated into a comprehensive reform measure, the effort is doomed to fail. Cost shifting, contradicting priorities, differing measures of success and evaluation methodologies will result in a confused, bifurcated system that serves neither population well.
Similarly, the problems emerging in Massachusetts and Maine make it less likely that states will successfully pursue reform measures. Instead, the states, a powerful lobbying group in and of themselves, will likely join others to support national reform.
As General Eric Shinseki, former Chief of Staff, U. S. Army, said “If you don’t like change, you’re going to like irrelevance even less.”
May
6
Another reason reform can’t be led by the states: they can’t deficit spend. Forty-nine of the 50 have articles or amendments to their constitutions requiring balanced budgets.
This kind of creates a double-whammy because in those years where let’s say times are bad in a given state, and more people need to take advantage of state subsidized care, those same years are also likely to be worse for tax revenues. Hard times would hit both sides of the ledger, and perhaps require some deficit spending which states can’t do.
Parenthetically, this is why — and I know there are some who disagree — attempts at a federal balanced budget amendment should be resisted. There simply are situations where it is necessary, and the federal government has the wherewithal to bounce back from it provided voters can force discipline from their members of Congress and the President.
Rick – an excellent point, and one that is perhaps as important as any I mentioned.
thanks Joe