Obstacles to Reform

The biggest obstacles to health care reform have little to do with legislation currently being considered by Congress. Obstacles like rising unemployment, a growing number of home foreclosures and the continuing economic instability are currently being magnified by an underlying public fear about the future. That fear is manifest in the ferocious disruptions of town-hall meetings with members of Congress, urged on by opponents of reform. Long exploited to stoke the “war on terror” and to combat “big government,” fear of the future seemed to many to have been conquered with the last presidential election. But now, given the ill effects at home of the global recession, fear is making a comeback.

President Obama’s economic stimulus has kept the financial tsunami from hitting with full force, and some economists claim that the Great Recession has bottomed out. Even so, many people are still suffering from its effects. And suffering is what voters see when they look at the data on foreclosures and unemployment, expected to reach 10 percent nationally in 2010 and already higher than that in some places. Voters still worry about the sagging value of their life savings and their home equity. Many look to President Obama to lead the nation out of the recession, but find it too early to assess his effectiveness. If all the efforts made by Mr. Obama and his team since January have not yet stabilized our economy, many wonder, will his ideas work for health care? The public needs convincing signs of economic recovery. As it waits for an upturn, the public appears to have suspended its hopes for the government’s broader agenda, including health care.

What happened? As recently as mid-June, according to a New York Times/CBS national poll, respondents indicated overwhelming support for substantial health care reform; they also favored a tax increase to extend health coverage to all Americans. Nearly three-quarters, including half of those who identified themselves as Republicans, favored a government-run insurance plan to compete with private insurers. Since then, however, more jobs have been lost, long-term unemployment has grown, and foreclosures have risen despite incentives given to banks to modify loans; many states are in fiscal distress and are considering tax increases. While waiting for the economic stimulus to work, voters have become more susceptible to the spread of misinformation by some opponents of reform, like Glenn Beck, Bill O’Reilly and Sarah Palin, who have taken advantage of the vacuum of hard information on health care to stir doubts about the president’s leadership.

Both major parties, focused on the coming 2010 Congressional election, know that the failure or success of health care reform, as well as progress on the economy, could determine the outcome of that election. As a result, partisanship is overtaking Congress even as it works on the reform bills. Ideological opponents have resorted to groundless fear-mongering, like the “death panel” rumor, to destroy any chance of success with health care reform, despite the benefits it could bring the country as a whole.

Passage of a strong health care reform bill could allay one of the deepest legitimate fears Americans have: that of going bankrupt because of illness. Currently, insurance companies can refuse coverage, drop coverage or raise premiums beyond reach for those with a pre-existing condition. The proposed House reform bill would outlaw such practices. Just as auto insurance is currently required of vehicle owners, the bill would require health insurance of individuals and employers; it would offer subsidies for those with low incomes and small businesses. It would also cut waste and curb costs. If the majority party were to pass such legislation without the help of Republicans, it might secure Democratic leadership for years. Such reform would also exemplify the change a majority thought they had embraced when they voted for Mr. Obama: a fairer, more compassionate America.

Health care reform would not solve the job or housing crisis, or send stocks soaring. But it would add the United States to the roster of developed nations with universal health care, where no family need be bankrupt or homeless because of illness or injury. Both parties understand that passage of an effective reform bill would have major political significance. That is what drives the misinformation campaigns and the scare tactics now reaching a fevered pitch.

Finally, Mr. Obama is correct to point out the relationship between health care reform and economic recovery. For the soaring costs of health care insurance and delivery, if unchecked, are unsustainable; they will leave us mired in debt. That is one more reason why these obstacles—joblessness, foreclosures, economic instability, fear of the future and partisanship—must be overcome, and why a strong health reform bill must be passed.

This article appears in August 31 2009.