'Harry and Louise,' the Sequel? The Universal Health Care Debate Is Back

Interesting article on one person's opinion on what has changed since Universal care was proposed in the 90's.  BD

In 1993, two unlikely public policy leaders took to the airwaves and in less than one minute helped to scuttle a health care reform bill that had been at the center of national debate. Broadcasting from their kitchen table, "Harry and Louise" leafed warily through a stack of documents representing the Clinton administration's universal health care proposal, commenting on its lack of individual choice and seemingly endless bureaucratic complications. "They choose, we lose," the two concluded.

What's Different Now?

The public, employers and the provider community are increasingly disillusioned by rising costs and increasingly complex plans. Employers, especially, are at a tipping point, and that might make a difference this time around. "As the cost of insurance rises, employers are shifting the increase to employees, and employees are getting angry.  Although employers are generally reluctant to cede power to government, they might be willing at this juncture to put the monkey on someone else's back."

The health care landscape is changing, too, with the recent introduction of a universal health care plan in Massachusetts and a highly publicized debate on the subject in California.  If health care reform does come in the U.S., it might be through a series of state-based initiatives, "Massachusetts is not an easy model to replicate; it's a state with adequate resources and a liberal outlook. A plan that works in Massachusetts wouldn't necessarily play in Kansas." Still, the fact that key states are moving in the direction of universal health care shows that there is substantial support for the ideal of reform -- and that will likely affect national as well as state-level politics.

"We have a very complicated health care delivery and payment system that has evolved over a long period of time. There are a lot of powerful vested interests, so change won't come easy.  Incremental change is far more likely. "It's probably the only way to get there from here. Given our history, politics and national character, sweeping health care reform would be too big a pill to swallow. But change in some form certainly seems inevitable; there's just too much dissatisfaction with the current situation." Try as they might, Harry and Louise -- or their current counterparts -- won't be able to hold on to the status quo indefinitely.

'Harry and Louise,' the Sequel? The Universal Health Care Debate Is Back - Knowledge@Wharton