Reinventing Health Care

IN WASHINGTON: Presidential compromise and muscle will be needed

March 12, 2009

The White House called it a summit, but with reformers and one-time naysayers, industry execs and consumers, lawmakers and lobbyists in the room with President Barack Obama, the gathering last week had the feeling of a health care love-fest. Everybody was on their best behavior, and the goodwill generated over the president's push to reform America's ailing health care system this year was made for prime-time.

But Mr. Obama has set for himself and stakeholders an ambitious goal that won't be realized without his input and political capital.

The president's markers are his campaign talking points on health care reform: expanded access, affordability, a public program competitive with private insurance, a payment model that emphasizes primary care and wellness, mandatory coverage for children, employer contributions and incentives and protections for small businesses.

These are broad objectives that give room to devise a way to overhaul a system that is too costly and provides poor outcomes. But the competing interests could grind this process to a halt without leadership from Mr. Obama.

Nancy-Ann DeParle, the president's new health czar, reportedly has the smarts, credentials (on the local and national health care scene) and experience (on Medicare and Medicaid reform) to monitor and provide direction to this monumental undertaking, which could cost $1 trillion. Ms. DeParle must be ready to exert some presidential muscle when Mr. Obama's favored compromise and consensus are in short supply. Mr. Obama has set aside $634 billion in his new budget as a down payment on his commitment to pay for it.

It's going to be a long slog. With a national plan in doubt, state and local governments should keep up their efforts to expand access to quality health care and Americans should insist on reforms that will better serve them and their country's health.

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