Pulling it Together: 19.7

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 four major moments of opportunity for health reform from Truman to the present day, as well as some other major legislative successes (Medicare and Medicaid) and failures (Jimmy Carter’s attempt at cost containment) since World War Two.


There are those who believe that the current moment of opportunity for health reform legislation will fade as others have before it. They believe that reaching consensus on how to reform health care and on how to pay for expanding and subsidizing coverage will prove too high a hill to climb.  Others believe that the planets are aligned for health reform now as never before; that public concern about paying health care bills in a deep recession and presidential and congressional leadership on health reform have created a truly unique opportunity if Congress and the President are able to move quickly to take advantage of it. There is no way to say for sure who has the better crystal ball here, but history does suggest one thing: with an average elapsed time of 19.7 years between major windows of opportunity for health reform it could be awhile if the current effort fizzles before the planets align again as they have today. Whatever the outcome this time, and whatever approach to health reform you favor, the problems health reform aims to address are real and worsening, and the prospect of another long wait certainly suggests that there is wisdom in making a maximum effort now.

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