Public Policy Update
By Lyle B. Dennis
The first four months of 2009 has been an extraordinarily active and productive time in Washington, DC. Since the swearing in of Congress on January 6 and President Obama on January 20, Congress has created a vast expansion of the State Children’s Health Insurance Program (SCHIP); passed a major economic stimulus bill that included $10 billion for NIH, $1.1 billion for comparative effectiveness research, $650 million for prevention and wellness funding and more; and, passed a $410 billion FY09 Omnibus Appropriation bill that funded the government through September 30, 2009.
And that was the easy part!
Now, Congress will turn its attention to the historically intractable problem of health care reform. And, even the most casual observer knows that reforming the health care system, which comprises approximately 17 percent of the entire economy of the United States, has proven to be an impossible task for many presidents and many members of Congress over the last 60 years.
• Harry Truman proposed universal medical coverage in 1950. It was widely derided as a socialist plot.
• Richard Nixon and Gerald Ford proposed universal coverage through an employer mandate in 1974. The legislation got swallowed up during Watergate.
• Bill Clinton proposed the Health Security Act in 1994. All but the youngest among us remember the story of what happened to that proposal.
• Barack Obama and the Congress are getting ready to take another run at this in 2009. How will this chapter end?
That question is, of course, not answerable today. Some believe this opportunity will quickly fade, as the forces of the status quo will prevail over the forces of change. Others find this a unique opportunity in which our expensive and inefficient care has finally reached a tipping point with the public, with large and small businesses and others that will result in genuine reform.
One thing is clear from the bullet points above. If reform does not occur this year, it will likely be many more years before it will arise again. Congress recognizes this and is pressing forward aggressively to make this a 2009 issue.
No fewer than two Senate committees and three House committees are working on this issue right now. The intent is to have legislation completed and considered in committee in June and passed through both houses in July. After Congress’s traditional August recess, that would lead to the House and Senate working out a compromise between their two versions in the fall, with the President signing the bill into law before Congress adjourns for the year.
That is the plan today; it has been the plan since January. It is often said, of course, that Congress has never set a deadline it could not miss! However, this is certainly the most serious effort to reform the health care system that we have seen in 15 years. The challenge is enormous. History argues that it won’t happen. But, nothing we have seen before included this combination of medical and economic need occurring together.
This electronic newsletter is a bi-weekly publication of AASLD and replaces the former bi-monthly print newsletter and weekly e-news. Members are welcome to submit articles and may send suggestions to atracy@aasld.org