Roll Call: Conditions Seem Right for Some Type of Health Reform to Pass

From Roll Call Contributing Writer Norman Ornstein: Back in March 1993, when we were just beginning the Clinton journey toward health care reform, I wrote an opinion piece in the Washington Post on the prospects for success. My central point was that there is a universal public definition of reform: I pay less.

Thus, any plan built around insuring the 37 million Americans then without coverage would violate the basic principle. The message to 250 million insured Americans would be: Congratulations, you are going to pay more so that they can pay less. I also noted the difficulty of enacting major change at a time when nearly three-fourths of Americans were happy with their health care, meaning overcoming the principle above would be even more difficult.

There were many reasons health care reform subsequently flamed out in 1994, but that principle was near the top of the list. What is different now? The answer is a whole lot, as underscored by the remarkable meeting at the White House on Monday with President Barack Obama shoulder to shoulder with the leaders of the insurance community, the hospital community, the pharmaceutical industry, the medical device companies and the Service Employees International Union, pledging to work together to cut skyrocketing health costs by 1.5 percent a year over the next 10 years. That might not sound like much, but thanks to the miracle of compound interest, reducing the base that much means $2 trillion in savings.

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I have met and spoken regularly over a number of years to leaders of these industries, including especially the American Association of Health Plans. The three representatives from the insurance industry, George Halvorson of Kaiser Permanente, Jay Gellert of Health Net and Karen Ignagni, the tough-minded and farsighted long-time leader of AHIP, all have seen the change coming and all have been preparing to be leaders and participants, rather than trying to deep-six a reform plan or just sit back and wait for the wagon wreck to happen. They have been joined by other leaders from hospitals and big pharma, and by the major figures in the medical device community and a key labor entity, SEIU, to create this unlikely alliance.

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