Proposals for health care reform face many barriers

Supporters of health care reform, each time they offered new proposals, expected "popular clamor" to "drive elected officials to end the national embarrassment of millions of uninsured and rein in health expenditures that were needlessly high and bought less than they should," but, each time, "reformers were right in their indictment and wrong in their political judgments," Henry Aaron, a senior fellow at the Brookings Institution, writes in a Los Angeles Times opinion piece.

He adds, "If there's any chance of success this time, we need to understand the barriers that prevented reform in the past," such as divisions about the specifics of proposals, concerns about change among U.S. residents with health insurance, concerns about the financial effects on the industry and differences in health care among states.

According to Aaron, "None of this means that sweeping transformation is impossible," but, "even if it succeeds, health care reform will not come from a single bill that transforms a $2.5-trillion industry but from repeated legislation of modest scope enacted over many years." He adds, "The next president can articulate a vision, but like Moses, he or she is unlikely to see the Promised Land" (Aaron, Los Angeles Times, 11/6).