I don’t know about you, but I’m starting to get pretty excited about the prospects for healthcare reform.
All the debating and posturing and hopes and skepticism are coming to a head. Speaker Nancy Pelosi promised the President that the House would pass reform legislation by the end of July. The Senate Finance Committee released its policy options for healthcare reform and has begun closed-door meetings to hammer out compromises on key differences, such as a whether to institute a public plan to compete with private insurers.
The insurance industry (which is still battling hard against the public plan) has agreed to other important compromises to extend affordable coverage to the uninsured, including community rating and guaranteed issue.
And hospitals, physicians and insurers jointly pledged to work toward the Administration’s goal of reducing healthcare costs by $2 trillion over 10 years.
The excitement that this pledge triggered caught me by surprise. Obama called it “a watershed event,” and one of my favorite economists Paul Krugman called it in his column “some of the best policy news I’ve heard in a long time” and wondered if this was the end for “Harry and Louise.”
It’s really not all that. (Krugman expressed enough skepticism in the same column to know that). As I pointed out two years ago, “Harry and Louise” were already in critical condition when America’s Health Insurance Plans declared, “Washington and the states should take immediate action to ensue that every American has healthcare coverage.” AHIP’s more recent commitment to individual health plan market reforms and expanded government oversight proved that this was a new game.
So why the outpouring of optimism–and why am I’m feeling excited? I think it’s the cumulative effect of all this movement toward reform, and the fact that it’s crunch time for policy makers and lobbyists on both sides of the aisle.
I’m still guessing no public plan or a highly watered-down version, which would be too bad. And I still think the healthcare industry’s joint pledge to cut costs will fray when push comes to shove. Plus there’s the little issue of how to pay for it all.
But either way, you’d have to admit that this time around the advantage goes to the reformers.
One last thing. You’ve got to hand it to Obama. He’s done a masterful job at framing the issue and pulling together rival factions. No wonder I voted for him.

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