“As much as Hillary [Clinton] is a lightening rod in some ways, she’s going to be driving the debate on this,” predicts Dr. Flansbaum. “As we get closer to the election and the second- and third-tier candidates start to come apart, she’ll be the one leading the healthcare debate.”
In general, Democrats and Republicans have settled into two camps on the issue.
“It’s easy to say, ‘Don’t listen to the Democrats—they want socialized medicine,’ while the Democrats are saying ‘The Republicans want corporate America to take over,’” says Dr. Flansbaum. “They’re playing games right now. I can’t say if a purely government or a purely corporate system would work, but we probably need and are going to get a mixture of both.” After the election, he says, “There’s got to be some compromise in the middle.”
What about other healthcare issues besides the rising costs and lack of access? “In addition to access, quality improvement is certainly key,” says Allendorf.
For Dr. Flansbaum, everything is connected to access, including healthcare IT, informatics, quality reporting, cost control, and waste reduction.
Hail to the New Chief
Once a new president and his or her administration is in place, will the concerns—and possibly the campaign promises—over healthcare access be dropped?
“Definitely something would—or rather, should—be done,” says Allendorf. “The two parties obviously have different philosophic approaches, but if [the next president] listens to the voters, they’ll act. The voters have spoken.” And if no action is taken on the issues, Allendorf adds, “It’s up to associations like SHM to push for reform.”
But Dr. Flansbaum warns that whatever the change is, it won’t happen overnight.
“There are too many lobbyists and people with their hand in the till to turn this around overnight,” states Dr. Flansbaum. “It will be an incremental change, and it will probably start out like the Massachusetts plan.”
Beginning July 1, Massachusetts enacted a law designed to cover the state’s uninsured population. The law mandates that individuals purchase health insurance with government subsidies to ensure affordability.
The two parties obviously have different philosophic approaches, but if [the next president] listens to the voters, they’ll act.
—Laura Allendorf, SHM’s senior adviser for advocacy and government affairs
Physician, Educate Thyself
The next year promises more campaigning, including debates and town hall forums, updated Web sites, media interviews, and so on. Allendorf says that as the candidates change and their positions on healthcare issues are fleshed out and become more apparent.
“SHM will provide information through our usual channels and publications about the candidates’ positions as they gel,” she says. “We’ll probably also want to hear from any SHM members who are involved in working with candidates on their positions, crafting proposals or working on healthcare advisory groups.”
For information on the candidates’ healthcare access positions, you can download an August report from the Council for Affordable Health Insurance, “The 2008 Presidential Candidates on Health Care Reform,” from www.cahi.org.
You can also find nonpartisan, up-to-date information about candidates’ healthcare policy, as well as analysis of health policy issues, regular public opinion surveys, and news coverage, on a site hosted by the Kaiser Family Foundation: www.health08.org. TH
Jane Jerrard has been writing for The Hospitalist since 2005.