Health reform – Pollyannas v Reality

I’ve been rather negative about the chances we’ll see major health care reform next year. That doesn’t mean the new Congress and President won’t address significant issues – expect major efforts to change physician reimbursement, enable HHS Sec-to-be Daschle to negotiate with big pharma, slash the Medicare Advantage subsidy, invest in Health IT and expand SCHIP coverage. These are really really big issues, and taking action on more than a couple would, in any other year, be seen as major change.
I’ll bet most of these initiatives will pass, making 2009 the most significant year for health legislation since 1964.
But the voices calling for a huge overhaul of the American health care delivery and financing system won’t be happy unless its a top to bottom overhaul of the entire delivery and reimbursement system. Methinks these well-meaning folks will find themselves unsatisfied, the victim of inflated expectations.
That would be unfortunate, to say the least. We’re moving in the right direction, there is significant momentum, and focus is on the right areas. What we don’t need is a pell-mell rush to pass universal coverage and worry about costs later.
There’s an old adage – if you don’t have time to do it right in the first place, what makes you think you’ll have time to fix it later?
If we screw it up on the front end, we’ll have zero political capital to clean up our mess.

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