Health care "is rising on the national agenda, but at least four things need to happen for this debate not to end in failure in the new Congress in 2009, as the last debate did in 1994," Drew Altman, president and CEO of the Kaiser Family Foundation, writes in a Boston Globe opinion piece.
Altman writes that first, "the pace-setting states with comprehensive health reform plans need to achieve at least some measure of success, or substantial momentum nationally will be lost." National health reform cannot be achieved "state by state because too many states lack the resources and the political will, but a few states" -- such as Massachusetts and California -- "can show the nation that it may be possible to break through the impasse between right and left on health reform with an amalgam approach that spreads the responsibility of paying for expanded coverage and builds a broad coalition strong enough to pass legislation," Altman says.
He continues, "Second, business, largely a paper tiger on national health reform in the past, has to engage for real this time and add its muscle to the debate when it is joined in Congress in 2009."
Altman writes, "Third, there will [be] no chance at legislation in the Congress in 2009 unless there is a big national debate about health reform in the presidential campaign." According to Altman, leading Democratic presidential candidates "are already talking about health," and for "the debate to be joined, the leading Republican candidates need to do the same." He notes that Republican candidates are starting to talk about health care and "almost certainly will" focus on health "as the field narrows and they get closer to the general election and need to woo independent voters," who "place a higher priority on health than the Republican base." Health is "rising as a concern for Republican voters too," he adds.
Lastly, "our political leaders" in 2009 "will need to show a willingness to compromise to achieve consensus, much as has been done in the cross-ideological approach in Massachusetts," Altman says. He adds that "it is unimaginable that the underlying ideological and policy divisions will have been transformed enough to produce support for a health reform plan that would fully satisfy the political right or left" and that "it will be a centrist bargain" on health care "or no bargain at all in 2009."