HEALTH REFORM: Our Year In Review

Health Policy -
December 24, 2008 - 10:07am

Before we give this blog (and our bloggers) a holiday break and wish our readers all the best for the New Year, we wanted to take a moment to look back at 2008 and look ahead, with some optimism, to 2009. Amid our challenges are opportunities, and amid those opportunities are the best chance in many years to fix our health care system so that it is both more equitable and more sustainable.

A year ago at this time, we weren't even sure whether health care would emerge as a leading issue in the 2008 primaries, whether it would resonate with voters. To the extent that candidates were talking about health reform, it was to a large extent a squabble among Democrats about mandates that most Americans probably didn't understand. But as the primary season wore on, we heard more and more about health care -- and, as former Arkansas Gov. Mike Huckabee reminded us, about wellness and prevention. Health care, after all, isn't just about payments and insurance and financing (and politics). It's about our health.

To their everlasting credit, candidates in both parties took our nation's health care crisis seriously and voters in both parties spoke up. Headlines may have focused on the disagreements about taxes, money and insurance markets; finding consensus on how best to expand coverage remains challenging. But what also emerged is that policymakers and politicians have an increasingly sophisticated understanding of the way our health care system has become outdated. How it focuses on acute care, when our society is facing an epidemic of chronic disease. How it rewards doctors and hospitals for providing lots of care, whether or not they are providing good care. How one in three dollars we spend on our health has little or no clinical value. An understanding of how we have to both figure out how to insure everyone and how to reinvent our health care delivery system so it makes sense, for our people's physical health and our country's fiscal health. Maybe not all politicians have said this in public yet. Maybe we are not quite at such a tipping point that reform can pass in 100 days. But it's what we here at New America's Health Policy Program have begun calling a "pre-tipping point" that will see major health reforms enacted maybe not in days or weeks, but in a reasonable, workable time frame. And that's progress.

Yes we enter 2009 with trepidation about our nation's economy, about what's ahead. But we also enter the New Year with hope. Inspired in part by the passion of Sen. Kennedy, leaders in both the House and Senate have already begun the hard work that an historic legislative initiative demands. President-elect Obama has made clear that health reform is a priority for his administration, not just a slogan for his campaign. He has shown that he understands that fixing health care is part of fixing our economy. Health care costs are part of what's wrong with Detroit and the auto industry. Part of what's hurting our ability to compete globally. Part of our housing and foreclosure crisis. Part of what's eating away at our small businesses. Part of what's hurting American families. So here's to 2009. Here's to hope.

Thank you and all the best -- Len Nichols, Joanne Kenen and the rest of the New America Health Policy Program.