Major Reform Debate Possible Next Year, Expert Says at 2008 Conference
Congress
Ron Pollack
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may put healthcare reform near the top of its agenda next year, which could give long-suffering advocates hope for success, and would definitely give them a huge challenge, one of the capital's leading health care activists told the Public Sector HealthCare Roundtable on Sept. 25."There is a real opportunity to do something with healthcare reform," Families USA Executive Director Ron Pollack said. "But it won't come easy." Pollack's comments came during the keynote address at the Roundtable's fourth annual conference in Alexandria, Va. Several dozen attendees heard presentations on healthcare reform from many perspectives at the two-day conference, the theme of which was "Preparing for Change." Pollack noted that, while surveys show that the economy is Americans' top concern, healthcare is a major part of the nation's economy, and this could nudge Congress to address spiraling healthcare costs and the lack of coverage for 46 million people. In addition, Congress will need to consider reauthorization of the State Children's Health Insurance Program early in the year, which will force lawmakers to confront healthcare issues. "There is no question that this Congress is going to be dealing with healthcare and healthcare coverage very early," Pollack said. Even if Congress takes up the issue, that is a long way from enacting a bill, and Pollack said three main lessons must be learned from the failures of many previous reform efforts:
- It is easier to stop legislation than to pass it, especially in the Senate. Super-majorities - therefore, bipartisanship - will be needed to construct and pass a plan that does not add to the deficit.
- There will be at least one major stakeholder opposing the plan. Even if it is only one, that opponent cannot be underestimated because "intensity often trumps numbers." (Also, see lesson No. 1.)
- Every key stakeholder in the past has been too wedded to their top priority proposal. When a given group's proposal was not included in the plan, that group often abandoned the reform effort, or, even, opposed it. Pollack quoted the observation that, "As a result, everybody's second favorite choice was the status quo." Advocates, he said, must be willing to accept an alternate plan that includes some of their priorities, but maybe not all of them; they need, he said, "to find virture out of second favorite choices."
The biggest challenge, of course, will be finding the hundreds of billions to trillions of dollars that it will cost to reform the healthcare system. While Pollack didn't offer a specific proposal, he did note that the income tax exemption for employer-provided health benefits reduces federal revenues by $220 billion a year. While he didn't suggest eliminating the exemption - as has Republican presidential candidate John McCain, who would replace it with tax credits for families and individuals - since this would almost certainly lead to millions of employers dropping coverage, he did say that the government could "maybe limit" it."We're not going to cover people who are uninsured with funny money," Pollack said. During the rest of the conference, Roundtable members heard from health care experts from Capitol Hill, the Obama campaign (a McCain campaign representative had been scheduled to appear but had to cancel), advocacy organizations, public sector groups and companies that provide services to the public sector. In addition, Roundtable Immediate Past President Jarvio Grevious, deputy executive officer for benefits for the California Public Employees' Retirement System, was presented with a plaque in honor of his service as the Roundtable's first president. See the Annual Conference page for a full round-up of the conference.
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