Thursday, March 10, 2016

Chewing over the future of health care reform

I've submitted a proposal to Netroots Nation for a panel on the future of healthcare reform, together with ACA Signups maven Charles Gaba, progressive activist and physician Paul Song,of the Courage Campaign, and Inside Heath Policy reporter Amy Lotven, a veteran of the ACA legislative wars.

The Netroots Nation conference is in St. Louis, July 14-17.  Sessions are chosen by member vote, at least in the first round; you can view sessions and vote (after a short signup if you're not a member) here.  Our session is Getting to Zero Percent Uninsured: Small Steps and Large Goals. Here's the pitch:

Panel Description

Obamacare has cut the uninsurance rate almost in half, but it's still left a bit more than 10% of the adult population uninsured, and a larger chunk underinsured. Where do we go from here? How can we make quality healthcare affordable to all without busting federal and state budgets?

That question suggests two others: what healthcare system would be ideal, and how can we move toward it given current US political realities? Combining long- and short-term thinking, we will consider healthcare reform 2.0 under the following circumstances:

1) What can a Democratic president do administratively? (more than you'd think)
2) What can be done with a GOP Congress?
3) What could be done with a Democratic Congress??
4) What could be done with a large Democratic majority?

Takeaways for attendees? Why is this session important to the progressive movement?

As the debate between Sanders's sweeping single-payer proposal and Clinton's laundry list of fixes and additions to the ACA highlights, progressives need to think hard about how (or whether) short-term steps advance a long-term vision. Should viable current steps move us toward single payer, for example by gradually extending Medicare (or Medicaid/CHIP) eligibility?  To what extent can blue states be labs for progressive advances (e.g., via ACA "innovation waivers" for states)? Can the ACA marketplace be improved by stricter regulation -- of rates, network adequacy and plan design? More broadly, do we want US healthcare in 20 years to look more like Canada's (single payer) or Switzerland's (private insurance with price controls?)

Why should the Netroots community vote for this session?

States have enormous flexibility, not widely recognized, to improve on and even completely reinvent the ACA, from enacting state-wide single payer to building a one-state public option or expanding a low-cost (Medicaid-like) Basic Health Plan to all  who need it. A progressive administration can also do a great deal administratively, without legislation (e.g., encourage state "innovation waiver" schemes, and undertake aggressive antitrust enforcement). Progressives need to consider the full range of tools at our disposal under a full range of possible political circumstances to make healthcare more affordable in a sustainable way.

1 comment:

  1. I like how you address this issue...but keep in mind that 21 states have not expanded medicaid...and if GOP Governors replace Democrats there will be a rescinding of that expansion....

    so it is good to talk about how we move forward...but changing the political climate and the state houses and the Congress is critical...