Editor's note: This is an expanded version of the story that appears in the Jan. 12 issue of Modern Healthcare magazine.
A decades-long push to fundamentally change how the healthcare sector looks, feels and operates will come to a head this year. But after countless tussles, numerous false starts and lingering bad feelings from the last tango with reform, an industry growing eager for change has found it hard to define what victory would look like.
So far, many agree that successful reform would include expanded coverage and access to care for the more than 45 million Americans who currently are without health insurance. And theres agreement, too, that any congressional platform to fix whats widely seen as a broken system must include ways to lower costs and raise quality over the long term.
But while those tenets have broad-based support, a number of hurdlesincluding ideological splits on the role the federal government should play and fiscal concerns over the overall cost of healthcare reformhave only raised more questions.
Still, not since the Clinton administration famously grappled with the issue in the early 1990s has Washington been so abuzz about the new congressional session and incoming administration. Part of the reason for this is that many of the same stakeholders who came to loggerheads over the Clinton plan are now playing nice, pushing an agreed-upon platform as a means to overhaul healthcare delivery in the U.S.
Clearly there are other factors that bolster the case for reform. Chief among them is the incoming Obama administration, which throughout the presidential campaign pitched a vision of greatly expanded health coverage and access regardless of socio-economic status. Exit polling showed that his message resonated with voters, many of whom named the rising cost of healthcare as a primary concern.
Another factor is the flat-lined economy, which policy analysts and economists alike have linked to heightened concerns over healthcare by the general public. With unemployment rising and a recession already a year old and counting, the ramifications of lost jobsand subsequently lost coverageresonate.
I think healthcare reform is real because its one of the top priorities for the (incoming) president; its real because hes got Tom Daschle running it for him and its real from the perspective that most view healthcare reform as part of the solution to dealing with the economy in the long-term, says Richard Pollack, executive vice president of advocacy and public policy at the American Hospital Association. Those three factors in and of themselves means were dealing with something very serious and very real.
Pollacks not alone in that thought. Mark McClellan, director of the Engelberg Center for Health Care Reform at the Brookings Institution and a former CMS administrator in the Bush administration, says that the U.S. has reached a tipping point when it comes to the healthcare crisis.
I think theres no question that 2009 is going to be the year for healthcare reform, McClellan says. The only question is how much and how quickly.