Kaiser Daily Health Policy Report
February 28, 2005
Opinion
by
Arnold Relman, New Republic:
U.S. health policies “have failed to meet national needs” during “the past four decades” because “they have been heavily influenced by the delusion that medical care is essentially a business,” and current proposals to shift to a more consumer-driven health care system “are likely to make our predicament even worse,” Relman, professor emeritus of medicine and social medicine at Harvard Medical School and former editor of the New England Journal of Medicine, writes in a New Republic opinion piece. The current rate of inflation in health care costs is “unsustainable,” and it is likely that any market-based solutions will fail to address the problem, Relman says. He adds that the United States should be prepared to establish a single-payer system that addresses fundamental problems in both the “insurance and delivery sides.” Relman concludes, “A real solution to our crisis will not be found until the public, the medical profession and the government reject the prevailing delusion that health care is best left to market forces” (Relman, New Republic, 3/7).
http://www.kaisernetwork.org/daily_reports/print_report.cfm?DR_ID=28377&dr_cat=3
Comment: For some time it has been clear that the single payer model of reform would provide a real solution to our health care crisis. But many voices have remained silent or muffled because of concerns about political feasibility. We’ve known that the feasibility of the single payer model is not the problem. It’s the politics. And more and more of us now realize that we must speak up if we ever expect to change the politics.
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Health Affairs
March 1, 2005
Voters And Health Care In The 2004 Election
By Robert J. Blendon, Mollyann Brodie, Drew E. Altman, John M. Benson,
and
Elizabeth C. Hamel
…no sweeping health reform proposal or large-scale effort to expand coverage for the uninsured is likely to gain serious consideration in the administration and Congress in the next few years. Many do believe, however, that the search for savings to reduce the federal deficit could result in new efforts to limit federal spending for both Medicare and Medicaid, and possibly in proposals to fundamentally restructure the Medicaid program, which now provides health insurance to some fifty million low-income, elderly, and disabled Americans. The Medicaid debate will likely unfold as part of the budget process, but, driven by the budget process and not by public opinion, it is likely to be the most consequential health care issue addressed on Capitol Hill in the next year in terms of the number of people affected and the dollars involved.
The question for the future is whether health care will once again make the transition from being a problem about which people have deep concerns to a voting issue, as it did in the 1992 presidential election. This may depend in part on whether health care can be framed as an issue of fundamental principles, rather than a series of complex health financing plans.
That it is not now a voting issue suggests that politicians will not feel compelled to mount major health care reform efforts, at least as long as other issues dominate. But the fact that health care costs and access are such strong personal and family worries also suggests that candidates and politicians who decide to champion health care issues can win favor with the American people for doing so.
The fact that personal concern about health care costs and access is already so high also suggests that raising awareness about these issues is not the paramount challenge for supporters of health care reform. Rather, the biggest challenge is to forge consensus on policy solutions and ways to pay for them that politicians can effectively champion.
http://content.healthaffairs.org/cgi/content/full/hlthaff.w5.86/DC1
Comment: Can we forge a consensus on policy solutions and ways to pay for them? If so, how?