Thursday, October 16, 2008

Goverment vs. market reform, liberals vs. conservative -No Soothsayer on Health Reform

I’m no soothsayer on health reform. But based on interviews I’ve conducted with Grace Marie Turner, founder and president of the Galen Institute and a McCain backer, and with David Cutler, PhD, a Harvard economist who is Obama’s chief health reform advisor, I predict prospects for health reform in the next administration are dim. The current financial crisis makes this a safe bet. There will not be enough money to go around, the budget deficit will be staggering, and health reform will have to wait.

Where one stands on reform depends on where one sits ideologically.

Here is a liberal physician’s view. David Blumenthal, MD, is an unpaid advisor to the Obama campaign for president,

The choice facing health care professionals. Like all Americans, is basic: Who deserves to be trusted with the stewardship of America’s health care system? The McCain proposal violates the bedrock principle that major health policy reform should first do no farm. It would risk the viability of employer sponsored insurance and the welfare of chronically ill Americans in a pell-mell pursuit of a radical vision of consumer-driven health care. Senator McCain’s plan does not demonstrate the kind of judgment needed in a potential commander in chief of our health system.

And here is the take of Joseph R. Antos, a PhD of health economics and the conservative American Enterprise Institute.

Reforms as sweeping as the Obama plan come with a high price tag. According to the campaign, federal health care spending could increase as much as $65 billion in a year but only after $200 billion a year in cost savings. The usual suspects show up as savers: health information technology, disease management, prevention, and comparative effectiveness research – all important ideas, but none liked to produce savings soon. ..Although the plan would significantly increase the number of Americans with health insurance, it remains to be seen whether that would come at a price Americans would be willing to pay.


1. Richard Reece, “Point Counterpoint: Two Experts Debate the Candidates Health Care Proposals,” Physician Practice Options, September, 2008.
2. Richard Reece, “What are the Prospects for Reform?” Physician Practice Options, September, 2008.
3. David Blumenthal, “Primum Non Nocere – The McCain Plan for Health Insecurity,” New England Journal of Medicine, October 16, 2008.
4. Joseph Antos, “Symptomatic Relief, But No Cure – The Obama Health Plan, New England Journal of Medicine, October 16, 2008.

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