Core Health Care Issues: The Politics

TW: I mentioned four health care issues yesterday, the fourth was the politics, I will hit that one first because in many ways it is the easiest. This quote is a propos:

From George Voinovich Repub. Sen. OH (retiring in '10)
"CNBC Host July 22nd: Senator, one question, before we go, on health care. How much of this disagreement with the administration is about the policy of health care and how to fix it, and how much of it is Republicans' obviously understandable desire to declaw the president politically. How much does that fit into the equation?

Voinovich: I think it's probably 50-50."

TW: I think Voinovich overstates the % so maybe 40% is pure Machiavellian political opposition. If Obama and the Dems get a health care reform package adopted a majority of Americans will see Obama has having done something to address a serious problem. Doing something regardless of the substance will be a huge political victory for Obama. The Republicans have little to gain by the Dems being perceived as addressing real problems.

Then you have say another 40% of the opposition being comprised of entrenched interests (i.e. unions, doctors, plaintiff attorneys, hospitals, insurance companies etc.).

Which leaves maybe 20% of the opposition being based on legitimate substantive differences on approaches.

When 80% of the opposition benefits from the status quo, changing the status quo becomes very challenging.

Ultimately this will come down to two questions:
1) do enough folks believe the status quo is unacceptable due to things like tens of millions of un- and under- insureds, lack of portable insurance, inequitable care?
2) will reform help or hinder the pursuit of slowing the growth in health care costs whilst concurrently addressing the above?

Personally I believe #1 is a moral imperative and can contribute significantly to #2 (more on that later). Re #2, the current growth rates in health care are unsustainable and the status quo will only perpetuate them hence reform is needed. To do nothing is to ignore legitimate societal needs and ultimately economically ineffective.

Despite my fretting I actually think a reform bill will be enacted by the end of the year. If it does not happen this year, then it will not happen anytime soon. But we have been down this path before, folks know that, Obama has learned from the Clintons he will get it done despite the forces of inertia.