There’s lots of talk about how the economic crisis (and the bailout, still in flux) will impact the prospects of major health reform in 2009.
There are some who think hopes for reform are scotched, including Robert Laszewski at the Health Care Marketplace and Policy Review, and Jeff Goldsmith at The Health Care Blog. And maybe Jim Lehrer, given the implications of his question that the candidates will have to “give up” portions of their plans. A down economy (and/or a bailout) would dry up the money that would be needed to pass health reform.
Parts of the counter-argument are made by Jane Sarasohn-Kahn at The Health Care Blog, and Ezra Klein at the American Prospect, and others. They argue that the economic times would create the political will and need for health reform, both from the public, and from the government that needs to find structural ways to address the issues in the existing health programs.
I would also say that this past week re-asserted a key concept in our political discourse: that government matters. Regardless of what you think of the substance of the bailout, or even the final outcome, there was bipartisan agreement that government action on big issues are possible and in fact necessary, that there are some things that only government can do. And if Congress can consider a $700 billion rescue of our financial markets, the leap for health reform is no longer so radical.
We should remember that the major social programs and leaps–Social Security, Medicare–happened during similarly tumultuous times. And to those who argue that a new President will have other issues on his plate (two wars, the economy, housing, energy, etc) to worry about, let’s also remember that transformational moments in American history are not single-issue events. The New Deal, the Great Society did not only focus on one issue. When we argue that health reform needs to be a priority, it is not at the exclusion of other issues: rather, the change that comes will be on several fronts. It is our job to insure that health care is part of that wave.