I attended a forum devoted to the Impact of the 2008 Presidential Election on Health Policy this morning in Boston, and found it to be rather interesting. Professor Robert Blendon from the Harvard School of Public Health and Professor Stuart Altman from Brandeis were particularly good. Former Lt. Governor Kerry Healey and former MA Democratic Party Chair Phil Johnston weren’t bad either.
Altman’s Law, formulated based on his experience in the Nixon Administration and again in the Clinton era: “Everyone supports some form of national health insurance, but if it’s not their plan then their preferred alternative is the status quo.”
He added that he hopes Altman’s Law is repealed in 09.
Driver of what happens after the election is whether the issue was a big one for the winning candidate, which in the case of health care and Obama it was.
There’s no possibility of adding taxes to the middle class to pay for health care expansion. Therefore whether or not programs receive significant expansion depends on whether Obama follows the Paul Krugman model (i.e., deficit spending during the depression –the more the better– is good) or chooses instead to listen to Harvard economists who tend to argue for a “down payment” strategy of expanding SCHIP and maybe a bit more
The health care issue Obama voters care most is cost –but they mean cost to them, personally, not cost as a percent of GDP
Unlike McCain voters, Obama voters don’t view individual responsibility as central to health reform. That means health care consumerism won’t be a big feature of any reform
President should let Congress develop the details of the plan and let Congress take credit.
Senators Baucus and Kennedy are well-aligned to lead in the Senate and to cooperate with Obama. (This was not the case under Clinton where Senator Moynihan wasn’t on board.) House leadership is much less certain.
December 5, 2008
- Allow states to innovate, by granting waivers as was done for Massachusetts
- Use the military health system as a test bed for health care delivery reform
- Focus on actions that can be taken unilaterally, such as signing people up who are eligible for existing programs but are not enrolled
- Persuade other rich countries to pay more for drugs so we can pay less