Health Care Reform: Political Realities

By Communications

From What's Happening at SHARE Blog

This is the fifth and final blog reporting back on SHARE's health care reform program held on Thursday, December 3rd. Here I'll look at some of the political realities that we have to consider when thinking about reform.

First, as Fran Visco of NBCC said at SHARE's program, the Obama administration's goal of health insurance reform didn't start with a mandate to provide everyone with access to quality care. It started with a number – a $900 billion cap and a directive to enact reform within this limited amount. The number is political, and doesn't necessarily have anything to do with the amount that's needed to really reform our system.

Second, the entire process of debating and passing the legislation is deeply politicized and partisan. And it's not only Republicans and Democrats who are pitted against one another, with Republicans overwhelmingly voting against reform. So-called Blue Dog Democrats who were elected with the slimmest margins in Republican districts are very leery of voting in favor of health care reform because they're afraid they won't get re-elected. Karen Orloff Kaplan of OCNA said the Senate Republicans wanted so badly to stall the bill that they tried to make it mandatory for the Democrats to read the legislation before the debate could begin – all 2,000 pages of it.

What does this mean for reform? I don't know, but there are two other things to keep in mind. First, as Fran Visco pointed out and others on the panel agreed, as difficult as it will be to get a bill enacted, this is just a baby step. Implementation is the real issue and will determine how health insurance reform will affect all of us. That's why NBCC calls for consumers to be involved wherever decisions are made about health care and wants consumers to comprise 25 percent of all decision-making bodies.

Second, we as individuals can play some role by communicating with legislators, as Karen Orloff Kaplan said. She recommends calling legislators, writing to them, sending them email, tweeting them – whatever way works best to communicate – so that you can let them know what you think, what you need, and what you won't accept. As she says, they may not read every word, but they know how to count, especially when it comes to counting votes.

Please feel free to leave comments. Let us know what you think about this process as it unfolds.

Posted December 14, 2009.