Managed Care - October 2008 - (Page 15) MEAN MORE REGULATION? Now, the iconic couple is an outspoken supporter of reform — without letting on just what that reform should look like. Their message today hasn’t been lost on the two presidential candidates. Both Barack Obama and John McCain have been wrestling over the title for chief change agent. Their widely divergent health plans offer a contrasting look at two radically different approaches to rearranging the market for health insurance in America. While the race for the presidency is a nail-biter, many health care analysts expect the cards will dictate a distinct shift in the all-important relationship between managed care companies and the politicians that control much of their fate. How voters realign power in Washington may well determine whether health plans can continue on a course that’s run for years, where the government has relied on industry to come up with innovative new products while balancing costs and premiums, or switch to a different path that relies on new government regulations to order the market and accommodate the uninsured. With analysts of every political stripe anticipating a rise in the number of Democrats in Congress, health plans haven’t been waiting for the final tally. Instead, the industry has been increasing its contributions to key Democrats as health plans brace for a new era of more hands-on government management. They are working to protect the future of lucrative programs such as Medicare Advantage, while starting a dialogue with newly elected politicians as well as a phalanx of powerful committee chiefs. In the meantime, several reform-minded advocacy groups say the realignment in Congress offers an unprecedented opportunity to move from the generic change they all call for to a specific, nonpartisan agenda that can gain swift legislative approval. In an attempt to break out of the political gridlock that has so often pushed other proposals into an early grave, these groups say they want a slate of proposals that any new president, Republican or Democrat, should be able to get behind. It’s all coming to a head during the worst economic crisis since the 1930s. Economy versus reform These days, when it comes to health insurance, it seems that everyone is for change. Lots of it. Coalitions combining business groups, consumer advocates, insurers, and labor outfits are prominent harbingers of change. Five groups got together to roll out the latest Harry and Louise commercial, including partners who don’t always see eye to eye on the issues. “Health care reform is a moral imperative,” Sister Carol Keehan, CEO of the Catholic Health Association, asserted when the coalition rolled out its campaign at the National Press Club in Washington. “We must keep reform at the top of our national priority list,” said Rich Umbdenstock, president and CEO of the American Hospital Association. “The health care situation is unsustainable if it continues like this,” said Todd Stottlemeyer, the CEO of the National Federation of Independent Business (NFIB), a small-business lobbying group that had grouped itself with the opposition coalition that Harry and Louise spoke for back in 1993. There are others. Divided We Fall includes the AARP, the Business Roundtable, the Service Employees International Union and, once again, the NFIB. Once again the emphasis is on urging a united front for health insurance that is affordable and available to all. A year ago, veteran congressional observer William Hoagland had been predicting that Hillary Clinton, an outspoken advocate of top-tobottom health care reform, would ride that sentiment all the way to the White House. Now Hoagland, who spent 30 years working for Senate Republicans before being named VP for public policy at Cigna and leader of its new Public Policy Group, is not so sure whether it will be Obama or McCain who will make it to the White House. In some respects, he says, it won’t matter. “Something is going to change,” says Hoagland. “But I doubt that it will be a major, comprehensive change.” OCTOBER 2008 / MANAGED CARE 15
For optimal viewing of this digital publication, please enable JavaScript and then refresh the page. If you would like to try to load the digital publication without using Flash Player detection, please click here.