Health Reform Likely in 2009, Political Insiders Say


SAN FRANCISCO — With a new president and a likely Democratic majority in the House and Senate, conditions will be ripe for health reform in early 2009, a bipartisan group of political insiders predicts.

The Democrats who spoke at Institute 2008, a meeting sponsored by America's Health Insurance Plans, were most certain of impending change. One Republican said he was optimistic, and two of his colleagues hedged their bets.

“I think something's going to happen in the next Congress,” said former Sen. John Breaux (D-La.). Sen. Breaux noted that Congress is likely to be “dramatically different” next year.

Terry McAuliffe, longtime aide to former President Clinton and Sen. Hillary Clinton (D-N.Y.), pointed out that 100 seats are up for grabs in the House and Senate.

He predicted that Democrats would take at least four to seven of the Senate seats and garner a majority in both houses of Congress.

Why is this important?

Traditionally, Democrats have called for bigger reforms and more government intervention, and Democratic presidential candidate Sen. Barack Obama (D-Ill.) is following that lead, Mr. McAuliffe said.

Despite concerns over the economy, energy prices, and taxes, “Health care will be the number one domestic issue” in the presidential campaign and in the Congress early next year because “it affects everybody,” he predicted. (See related editorial, page 9.)

“I do think health care will be still at the top of the list of things that need to get done,” agreed Sen. Breaux.

Tommy G. Thompson, who served as Health and Human Services secretary under President George W. Bush, agreed with the Democrats that health reform was likely next year.

He said he was optimistic because candidates for the House and Senate and both presidential contenders were talking about reform. “That tells me that 2009 is going to be the biggest year we've ever had,” said Mr. Thompson, who is also a former governor of Wisconsin.

He said there were many pressing issues to address, including a looming shortage of physicians and nurses and the predicted bankruptcy of the Medicare Hospital Insurance Trust Fund in the next 5-10 years.

Former Sen. Bill Frist (R-Tenn.) agreed with Mr. Thompson that the Medicare trust fund would get lawmakers' attention early in the next Congress.

But, Sen. Frist opined, “I'm not quite as optimistic that we'll see reform.”

Sen. Frist said he does not think health care reform will be a priority until the American people make it one. In 1993, during the last major attempt at reform, 42% of Americans said the old system needed to be scrapped; “today we're at 34%.”

And, he said, the cost of adding coverage will have to be addressed, which could create some unsettling political realities.

Dan Bartlett, who served as President George W. Bush's communications director and counselor, agreed, noting that Sen. Obama had not been discussing details of his health proposals in the early going on the campaign trail.

Like Sen. Frist, Mr. Bartlett said he did not see reform as an imperative.

“I don't see the mandate coming out of this election,” he said, adding, “I think you'll see incremental change, but I don't think you'll see radical change.”

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