Lola Butcher

One of the people with the most hands-on health reform experience in America is losing confidence that  much hoped-for federal-level reform will occur after the presidential election.

Jon Kingsdale, executive director of the Commonwealth Connector in Massachusetts, told me that America’s economic implosion may endanger the chances of health care reform proposals.

Clearly there’s a lot of interest and it’s a big domestic policy priority. Senator Obama has, in particular, identified that as a priority. However, the straightened financial circumstances are such that, on the one hand, there may be all the more need for it, but on the other hand, far fewer federal and state resources are available to finance reform. So, myself, I’m a little bit less optimistic than before the recent financial services meltdown and the accompanying federal bail-out. But I wouldn’t rule it out.

Kingsdale will speak at the 6th Annual World Health Care Congress in Washington DC.  One of the “lessons learned” from the Massachusetts experience is that, while waiting for legislators to turn their attention to health reform, the private sector can take a lead. Kingsdale appreciates “the tremendous effort that went into it on the part of private sector groups to try to promote reform, really for two or three years before the legislature even enacted something.”

That coalition of support, which is very broad, has stayed actively involved in the implementation as well. And that’s just, I think, a critical lesson. You know, frankly, we did health reform here 20 years ago under Governor Dukakis by a slim, it passed by a slim, slim majority, and never really was implemented. By contrast, there’s a very broad consensus here, and we’ve done everything we can in a difficult implementation process to actually build on and enhance that consensus.

It is always surprising to me that physicians perceive themselves to be victims of America’s health care crisis when, in fact, they are the only ones that can save the system. I don’t blame physicians for the problems–there is too much blame to go around to pin it on just one group–but physicians alone have the power to sabotage any proposed reforms.

That’s real power, and that means physicians must be on board with any changes designed to return from the brink. And the only way they will be truly on board is if they help design the changes. Physicians, America needs you to apply the intelligence that got you through medical school to the nation’s health care quality and cost crisis. No, most of you did not sign up for this when you decided to become a physician, but you are the key to solving this mess. So please, proceed with haste.

Robert Laszewski, president of Health Policy and Strategy Associates and one of health care’s truth tellers, says this nicely in his recent post.

The Medicare Payment Advisory Commission, which guides the nation’s largest health care payer, is suggesting major changes to the way health care is delivered in America. 

The high cost of health care threatens to overwhelm the United States’ ability to pay for it–and yet the growth of the health care industry is the one bright spot on the country’s economic radar screen.

Huh?

When Peter Orszag, director of the Congressional Budget Office, testifies before the Senate Finance Committee at its health reform summit next week, we can be sure he will pound the drum he has been beating for more than a year: “The rising cost of health care represents the nation’s single most important long-term fiscal challenge.”

And yet the health care industry may be the economy’s savior, reports today’s Washington Post:

By 2016, the Bureau of Labor Statistics predicts health-care employment to double the projected growth of all other industries combined.

“It’s one of those industries that doesn’t seem to be affected by economic downturn,” said Terry Schau, an economist at the bureau. “People get sick, and they’re going to need health care. The state of the economy may affect their ability to pay but not the demand.”