Health Reform Prospects

Posted April 06, 2009, at 6:06 p.m.

A major reform of the American health care system at last seems to be in sight, although there are some serious ifs. Addressing those ifs is key to changing an unaffordable and often ineffective system that is badly in need of change.

On the positive side, President Obama has made it one of his top goals and proposed expenditure of more than $600 billion over 10 years for a starter. He plans to supervise the effort but has asked Congress to work out the details.

The Democratic chairmen of five key congressional committees have agreed on the main points of legislation. They want everyone to carry insurance, with employers help to pay for it, plus a government health insurance plan as an alternative to private insurance.

In Bangor, Sen. Olympia Snowe will lead a public health care reform “listening session” from 9:30 to 11:30 a.m. Wednesday at the Richard E. Dyke Center for Family Business at Husson University. Participants are expected to include representatives of the health care industry, advocacy groups, state officials, business organizations and consumers. Similar sessions are being held throughout the country in an effort to produce a national consensus.

Practically everyone seems to agree that major reform is urgently needed, since the cost of American heath care is mounting at a rapid and unsustainable rate. At the same time, millions lack or have only inadequate health care. Their ranks are mounting by the day. And the growing numbers of un-employed include many who have lost their health care benefits. Universal coverage seems to be gaining popularity.

Sen. Edward M. Kennedy, D-Mass., although under treatment for a malignant brain tumor, is leading the congressional drive for votes on various bills by the end of July.

The growing burden of health benefit costs has persuaded many business owners to join the demand for reform. And even the insurance industry, which fought and helped destroy the Clinton administration’s health plan, now seems eager to take part in drastic change.

Disagreements lie ahead, starting with how to pay for it all, although the president contends that reform will bring long-term savings from the costly present system. A sharp line divides those who demand a single-payer system similar to those in many other developed countries and those who want no expansion at all of government health care. Many Americans like their current health plans and fear any change.

Success will depend mainly on compromise and transparency. No special interests will get exactly what they want, so all must give some ground. And the general public will not trust a plan that is drafted in secrecy and thrust upon them.

Bipartisanship would be best. But if the Republicans present almost total opposition, as they have against other Obama administration proposals, the Senate Democrats might do it alone, using budgetary reconciliation to go for a 50-vote majority instead the 60 needed to avoid a filibuster.

With health care, like so many other issues, the country faces an urgent need and a good opportunity for change, but probably a tough struggle to get meaningful reform.

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