Health reform policies and implementation

Health Reform Prospects

"Health Reform: A Bipartisan View" by Jim Cooper and Michael Castle, begins and ends with the proposition that incoming President Barack Obama can achieve the goal of providing health coverage for all Americans. The authors base their argument on the idea that Barack Obama is assembling a talented team that can at last overcome partisan objects, and deal deftly with the enormous costs of the current American healthcare system. In their opinion, the reforming of healthcare is not only a necessary accomplishment for the future well-being of the nation, but also an excellent first step in building up support for the future president's agenda. They speak of the honeymoon enjoyed by all presidents during their first six months in office, and speculate that, by espousing such a popular endeavor, Obama can succeed in extending that honeymoon, building up "political capital," (Cooper and Castle, 2009, p. 1) that can be used toward succeeding ventures. Central to Obama's impending success, state the authors, is the existence of a ready-made healthcare plan in the form of a pending bill entitled the Wyden-Bennett Healthy Americans Act. Wyden-Bennett accords to all Americans access to a health plan identical to that enjoyed by members of Congress. The bill also would continue Americans' access to private insurers, and so settle questions of doctor choice and governmental interference in individual Americans personal health choices.

Nevertheless, Cooper and Castle recognize that such questions remain major obstacles in achieving major healthcare reform. In addition to notions of government interference, they cite concerns over the financial costs of such extensive changes, especially at a time of economic crisis. Problems of cost are addressed by reference to the testimony of Peter Orszag of the Office of Management and Budget in regard to current waste in the medical sector. Orszag declares that some $700 billion can be saved simply by reining in current waste (Cooper and Castle, 2009, p. 2). Orszag is, along with Senator Daschle, one of two experts mentioned as examples of Team Obama's political acumen, and ability to cut through government red tape, and partisan bickering. Partisan bickering is indeed another of the major obstacles noted by Cooper and Castle. Recognizing the need to secure bipartisan majority support, the authors reinforce their argument with a quotation from Thomas Jefferson -- "Great initiatives cannot be passed on slender majorities" (Cooper and Castle, 2009, p. 2). Jefferson's observation also calls attention to the fact that Democrats, at the time of the article's writing, controlled only 59 seats out of 100 in the Senate -- not enough to block a Republican filibuster. Special interest groups further add to the complexities of the situation, as do concerns of government intrusion in the private lives of American men and women. Many special interest groups condemn the healthcare reform proposals as examples of "socialized medicine," an attack the authors dismiss as ridiculous in light of the recent government bailouts of private corporations (Cooper and Castle, 2009, p. 3). They urge reformers to work toward the "good," rather than simply the "best," where best takes on the idea of political compromise; compromise that will handicap true healthcare reform.

Still, the authors appeal to the momentous nature and long history of the campaign for healthcare reform. Passage of Wyden-Bennett would represent the culmination of efforts going back to the time of President Truman, and represent a fitting cap to the career of Senator Ted Kennedy (Cooper and Castle, 2009, p. 3). Cooper and Castle list a range of congressional luminaries to back up the inherent nobility of the cause, and its deep bipartisan backing. Wyden-Bennett is portrayed as the universal antidote to a limited system. Current employer-based health insurance covers only a portion of the American population. It is also extremely expense and is increasingly treated as an unneeded financial burden by companies eager to cut costs. Wyden-Bennett, in contrast, will "redistribute" existing federal expenditures, taking dollars away from those in high-paying positions, and giving them to those who genuinely need the additional help (Cooper and Castle, 2009, p. 4). Cooper and castle feel that the universal aims of the program, coupled with the program's redistributive intent, will prevent congressional fence-sitters from voting against a plan that is so obviously in the best interests of the vast majority of working Americans. Ultimately, the bill's appeal to social justice will bridge the partisan divide, and provide President Barack Obama with a firm foundation on which to build future change.

Of course, change, especially necessary change, is in the eye of the beholder, as are partisanship and bipartisanship. Cooper and Castle call their piece a "bipartisan view," but appear to spell out a largely Democratic approach to healthcare reform, one that seems specifically designed to entrench President Obama's position, and guarantee his reelection. They laud the expected, intended, or proposed actions of a man who has not yet taken office. Many of the authors' supporting arguments have already been rendered moot: Senator Daschle was knocked out of the running almost immediately, and higher taxes are already included in current bills. Further, the authors take much for granted in their positions on healthcare reform supposing, from the outset, that virtually all Americans seek a drastic overhaul of the current system. They speak of the enormous costs involved in providing adequate medical care, and address waste within the industry and federal programs, like Medicare and Medicaid (Cooper and Castle, 2009, p. 3), but do not look into the underlying issue of why healthcare costs have risen so dramatically in recent decades. They seem to infer overbilling and mismanagement, but do not examine why doctors and hospitals charge such exorbitant fees even when not employing high-tech equipment or cutting edge methods. Nor, do the authors of the article address fundamental assumptions about American society from any point-of-view other than their own. They take it as a given that all thinking Americans seek redistribution of wealth; the movement of funds from private medical plans to public assistance programs (Cooper and Castle, 2009, p. 4). Neither do Cooper and Castle address the underlying concerns over what constitutes a true democratic "reform" of a major sector of American life. At the time of the writing of the article, the Democratic majority in Congress was not filibuster-proof, and has become only barely so today. Sixty votes for out of a total of one hundred, equal forty percent against. Forty percent is a sizable share of the American electorate. To compel forty percent of the population to adopt radical changes with which they may not, or do not, agree is tantamount to forcing scores of millions of Americans to adopt changes they do not desire. A private club or organization with one hundred members that permits sixty members to institute radical changes against the wishes of the other forty members would soon be a club or organization with only forty members. Government policymakers, from the President to members of Congress, must remember that they represent all Americans. Working toward "best" policies is often a good idea, as it indicates compromise, and an attempt to reach actual consensus.