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  • Pulling it Together: On Health Reform, Will All Roads Meet in the Middle?

    Perspective

    A few weeks ago a small group of upset single-payer advocates followed Senator Baucus into the parking garage of our D.C. building as he was arriving to do one of our health reform newsmaker breakfasts, cosponsored by Families USA and the National Federation of Independent Business. They were angry because they feel that single payer is not receiving enough attention in the current debate, and it is true that it is not getting a lot…

  • Pulling it Together: The Experts vs. The Public on Health Reform

    Perspective

    In repeated Kaiser polls, we see a divide between what experts believe and what the public believes about some of the key issues in health reform. They don’t disagree on everything; far from it. But there is a wide gulf on basic beliefs about what is behind the problems in the health care system and key elements of reform, especially delivery reform. Experts believe the health care system is full of unnecessary care and troubling…

  • Pulling it Together: The Health Care Industry’s Second Voluntary Effort

    Perspective

    The announcement that health care industry groups plan to put on the table voluntarily a package of proposals to shave $2 trillion off the rate of increase in health spending over the next ten years immediately conjures up the image of the Voluntary Effort or VE launched with similar fanfare in the Carter administration.  Back then the industry used the VE to fend off Jimmy Carter's efforts to aggressively control the costs of hospital care…

  • Pulling it Together: About Kaiser Health News

    Perspective

    There is lots of apocalyptic talk these days about the collapse of the newspaper industry and the challenges facing news organizations.  There is even talk of the unimaginable, my hometown paper The Boston Globe shutting down. Surely they know that Red Sox Nation cannot exist without the Globe Sports pages. All kinds of solutions have been proposed, from micro-payments for news stories like songs on iTunes to foundation-endowed daily newspapers.  There is growing talk of…

  • Pulling it Together: 19.7

    Perspective

    Several years ago Joanne Silberner from NPR offered some advice I liked. Joanne said that the secret to effective communication was to "have a killer anecdote and a killer number." Here is a killer number: 19.7. That's the average number of years between major attempts at health reform since Harry Truman made health reform a top priority and his plan was branded a socialist plot and soundly defeated in 1950. The chart below chronicles the…

  • Pulling It Together: Jobs, A Reason to Fast Track Coverage

    Perspective

    The two big topics in Washington right now are the economy and health care.  I've written before about how the two are linked, and in particular about how among the everyday economic problems people are having, paying for health care is a big one. But the latest numbers out from the Bureau of Labor Statistics show there is another link: Health care is one of the few relatively healthy parts of our unhealthy economy right now. Since…

  • Pulling it Together: What Will Health Reform Do For Me?

    Perspective

    There is one poll number that may be more important to watch than any other if we have a big debate about health reform: The percentage of Americans who think that they or their families would be better off if the president and the Congress enacted major health reform legislation. It's a number that signals whether people think that health reform legislation will actually help them with the problems they are having in the current…

  • Pulling it Together from Drew Altman: Multiple Agendas for Controlling Health Care Costs

    Perspective

    In what would be a domestic policy trifecta, we may be headed for interconnected big debates about economic recovery, entitlement programs and health reform. A core issue in the entitlement and health reform debates is the problem of rising health care costs. President Obama, now apparently fully briefed on the economic, budget and health reform realities he faces, is talking conspicuously about hard choices that may lie ahead. In a short period of time the…

  • Pulling It Together: The “R” Word Is Back

    Perspective

    Longer ago than I care to admit, I got my start in health policy at M.I.T. when I wrote a book about health care regulation. The book was about a long forgotten attempt to rationalize the health care system through an elaborate health planning program set up in the seventies under the National Health Planning and Resources Development Act. It established a system of federal, state and regional planning bodies to control health care costs by limiting the supply of…

  • Pulling It Together: Keeping the Health Reform Coalition Together

    Perspective

    We could be headed for a new schism in the debate about health reform. Not the familiar gulf between advocates of the market and government, or the predictable one between deficit hawks and spenders, but a new one that crosses traditional partisan and ideological lines between advocates of long-term reform of the health care delivery system, and immediate help for the uninsured and insured struggling with health care costs.  This new rift is most likely to develop if tight money and a crowded agenda…