Tea Leaves

It’s Not Just Politics

The newly elected members of the upcoming 112th US Congress have vowed to dismantle (or halt) the Patient Protection and Affordable Care Act (PPACA).   Mr. John A. Boehner (R. Ohio), the new House Majority Leader, promises to replace it with “a common-sense approach to health care reform” (Boehner, 10/15/10).  Many news analysts predict that the White House will counter with a generous application of the Presidential veto.

So, once again we are encouraged to take a “wait and see” attitude about health reform.  After all, with or without compromise, big policy change takes time and government always has the advantage of time.   However I remind you that while health care reform is a political issue —  it is not limited to politics.    Ideas are the ultimate durable good and the market is already adopting ideas that are contained in the PPACA.  This week’s lead article on Accountability Care Organizations is an example.   Verity Reports has also previously noted how insurance companies are negotiating cost bundling agreements with providers.

My firmed looked at the US Chamber of Commerce list of health reform priorities to give you a hint of which other components of the PPACA may have traction outside the public policy arena.  The Chamber outlines a three-prong approach to health reform: 1) get costs under control, 2) reform the insurance system, and3) create a vibrant market place.  This approach supports the development of health information technology and comparative effectiveness research.  It emphasizes the importance of health wellness and preventive care.  It supports pay-for-performance, consumer-driven health options and long-term care reform.  The Chamber also supports eliminating the use of pre-existing conditions or health status in insuring individuals, obligating individuals to obtain health insurance coverage, and creating subsidies for individuals who cannot afford coverage.

To be sure the Chamber takes real issue with the refusal  of the Congress to move forward with other issues that are critical to its members such as tort reform.  Neither is the Chamber satisfied with how businesses may be effected by policies such as state insurance risk pools.   But on the surface their agenda has a good deal in common with PPACA.    The devil may be in the details but it appears that you can’t keep a good idea down.

Tea Leaves is an opinion column written by Colette Knuth.  Dr. Knuth is a doctorate-level trained health policy analyst and CEO of The Colette Steward Group.  The Colette Steward Group provides health policy research and organizational development services to the health care sector.  Visit us at: www.thestewardgroup.com.