Monday, January 12, 2009

Health Care Reform––Are the Adults Taking Over?

In past posts I have pointed to what I called the “irrational exuberance” over health care reform––that the excitement over the new administration and its ability to accomplish all the big things was getting out of hand.

There was even talk that Democrats would use the Senate budget reconciliation process and bypass the 60-vote rule enabling them to use their big new majorities to ram their idea of health care reform through.

I warned that health care was too big and too complex an issue for partisanship and any overconfidence or unilateral behavior would simply backfire.

That’s why I was encouraged to hear incoming HHS Secretary Tom Daschle say at his confirmation hearings that the administration would not use the simple majority budget rules to pass health care reform. That would also be in keeping with President-elect Obama’s pledge to generally be more bipartisan.

In my mind, bipartisanship is the only way health care reform can occur.

The President-elect, facing the financial crisis, has also been unwilling to say in recent interviews that raising taxes for those making over $250,000 is still on the table as a way to pay for health care reform. Obama also said this weekend, "I want to be realistic here––not everything that we talked about during the campaign are we going to be able to do on the pace that we had hoped"

The House will also take up a SCHIP reauthorization and extension this week. It is clear that the Democratic Congressional leadership does not want to risk getting a bipartisan SCHIP agreement bogged down in any long and uncertain national health care debate––a wise move.

In recent posts I have pointed to the importance of the recent CBO work itemizing the cost and savings potentials for health care reform. That report is a daunting outline for just how difficult health care reform can be. I have also written about the lack of consensus on the really core issues in health care reform—starting with provider payment reform.

It is critically important that health care reform be achieved. But it will never be achieved with another naive suicide charge led by people who don’t understand just how much real work has yet to be done to bring the key stakeholders onside.

This week there are some indications the “irrational exuberance” of December may be waning and the adults may be taking charge. That would be good.

Recent post: CBO to Health Care Reformers: Naive Policy Makers Need Not Apply
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