Health Care Reform is Obama’s Waterloo

November 25, 2009

By David Coates

As health care reform legislation moves to the Senate floor for debate later this month, the stakes are high for President Obama and the nation. Health care reform is Obama’s Waterloo. He has to win this one. A loss on the health care front would lead to losses on future key legislation as well. If Obama loses health care, he will lose immigration.

In order to pass health care reform, the two sides must consider the following key points.

“The Perfect Must Not Drive Out the Good” – While the current legislation is far from perfect, it does pave the way for important changes in the U.S. health care system that could ease the anxiety level among Americans. We want to get to the point where health care is not something Americans worry about. Even though there is a widespread belief that we have the finest health care system in the world, we also have a higher level of anxiety than any other country about the cost and availability of the heath care that makes us so proud.

“Weakness on the Cost Side Must Not Prevent Reform on Access” – Much of the opposition to reform is focused on the costs involved, but there is a critical need to broaden access to health care in the U.S. now. The current reforms would only be Round 1, with Round 2 to follow as the cost implications play themselves out. Paradoxically, the public option, which Republicans oppose, is the very provision that would drive down costs by providing competition for private insurance companies.

“Health Care Reform Would Stimulate the Economy” – The U.S. health care system accounts for 1/6 of the economy and employs 14 million people. New players on the demand side would provide an economic stimulus, whereas the status quo will lead to escalating costs and stagnation.

Informed discussion on these and other issues is the key to overcoming the current divide.

Health care is arguably the most important political issue touching the daily lives of each of us, yet deep ideological differences scar the political landscape. The final settlement will be a compromise satisfying neither extreme, but definitely privileging access over costs with proposals designed to widen and deepen access to health care.

David Coates is a political science professor at Wake Forest University and a frequent speaker on health care reform. For interviews with him, contact Carol Cirulli Lanham at 972-818-0895.

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