A historical look at health refom

Aug 12 2009

Several news organizations offered historical looks at health reform and explainers on specific proposals.

"President Barack Obama's campaign for a health care overhaul is an intense installment in a long-running story, dating to Theodore Roosevelt in 1912," The Associated Press reports. Roosevelt's efforts were not successful, and since then, "the basic issue, affordable health care for all Americans, has not changed. But possible solutions have not evolved either, in part because new proposals seldom build on old ones. Obama's broad, leave-the-details-to-Congress proposal has little in common with the 1,300-page measure President Bill Clinton couldn't even get to a vote in a Democratic Senate in 1993." Presidents Franklin D. Roosevelt, Dwight D. Eisenhower and John F. Kennedy also failed to enact the health care changes they had proposed. "Lyndon B. Johnson did, but even with his legendary legislative skills and the overwhelming Democratic majorities in Congress after the 1964 elections, it took more than a year of hard, sometimes arm-bending persuasion to get Medicare enacted" (Mears, 8/12).

NPR reports that lawmakers "might want to think back to a time when Congress attempted a massive bill affecting every American and every special interest group — much as health care legislation is doing now." In 1986, after "many months and furious negotiations," Congress passed a tax restructuring. "'Congress, which usually does only two things well — overreact and nothing — can actually pull itself together and write remarkable legislation that will deal with issues,' says Jeffrey Birnbaum, who covered the tax fight for The Wall Street Journal. 'It did in '86 and it could very well [do it again] on health care reform, despite the many doubters, but it would take an extraordinary confluence of events and personalities for something like that to happen again'" (Wertheimer, 8/11).

In a separate story, NPR assesses whether insurance exchanges would help cut health costs. "The insurance exchange would operate much like a stock exchange, but instead of stocks, shoppers can purchase different health insurance plans. The idea is that those who don't like their insurance, or don't have any at all, can go to the exchange and choose from a variety of different health insurance providers, big and small. For those Americans who like the insurance they have, President Obama has said they can keep their plan." A public plan could keep costs down, but one possible risk is that "the number of individuals and small businesses that qualify for the exchange may be too small, and there might not be enough volume to create competition. Or, conversely, if it turns out that too many people sign up only when they get sick, or sign up for a few months at a time then drop their policy, companies won't be able to break even. In that case, the exchange won't save anyone any money at all" (Neel, 8/12).

Reuters reports on a proposal for health care cooperatives. "The government would offer start-up money -- Conrad said $6 billion would be needed -- in loans and grants to help doctors, hospitals, businesses and other groups form nonprofit cooperative networks to obtain and provide healthcare. … Co-op membership would be offered through state insurance exchanges where small businesses and individuals without employer-sponsored plans would shop for health coverage. The co-ops would function as a mutual insurance company where policyholders would have some ownership rights. Conrad said co-ops could quickly bring health insurance to some 12 million people, which would make this the third-largest insurer in the country" (8/11).