Our Health Policy Matters

Newly re-elected President Barack Obama may now have a new road to health policy-making after three years of defending the Affordable Care Act.  And even if the Congress does nothing to help in the months to come, his road may be a whole lot easier than it has been. Even with the Affordable Care Act in place, our health policy debate has been dominated by the belief that health care Armageddon is just around the corner. But some recent data suggest that Armageddon may still be down the road. Just how far may well determine how our health policy debate shakes out over the next two years. First, let's look at the Armageddon scenario. The candidates accepted the scenario that health care costs are out of control when they made the future of Medicare and Medicaid a centerpiece of the campaign.  Governor Romney’s proposed solution was to clamp down on federal funding for these programs.  President Obama advocated managing state and local costs by expa...

Newly re-elected President Barack Obama may now have a new road to health policy-making after three years of defending the Affordable Care Act.  And even if the Congress does nothing to help in the months to come, his road may be a whole lot easier than it has been. Even with the Affordable Care Act in place, our health policy debate has been dominated by the belief that health care Armageddon is just around the corner. But some recent data suggest that Armageddon may still be down the road. Just how far may well determine how our health policy debate shakes out over the next two years. First, let's look at the Armageddon scenario. The candidates accepted the scenario that health care costs are out of control when they made the future of Medicare and Medicaid a centerpiece of the campaign.  Governor Romney’s proposed solution was to clamp down on federal funding for these programs.  President Obama advocated managing state and local costs by expa...

I wrote a column in January entitled A Dime’s Worth of Difference in 2012 . The central premise of the column was that this year’s health policy debate would fall short of what we needed.  It would instead resonate with the words “Obamacare,” “Romneycare,” “government takeover,” and “individual mandate.”  That is exactly what we got – and then some. But we needed something more. We needed an honest debate about: the future of Medicare for our elders; the importance of Medicaid to people with chronic conditions; the growing mental health needs of our population – including our returning veterans; the essential role of public health in our lives, no matter what our socioeconomic status; the fact that health and social assistance providers are the real job creators in our 21 st century economy, and must play a key role in our recovery from recession. What we experienced instead was a tsunami of concern for our more selfish instincts – that w...

I wrote a column in January entitled A Dime’s Worth of Difference in 2012 . The central premise of the column was that this year’s health policy debate would fall short of what we needed.  It would instead resonate with the words “Obamacare,” “Romneycare,” “government takeover,” and “individual mandate.”  That is exactly what we got – and then some. But we needed something more. We needed an honest debate about: the future of Medicare for our elders; the importance of Medicaid to people with chronic conditions; the growing mental health needs of our population – including our returning veterans; the essential role of public health in our lives, no matter what our socioeconomic status; the fact that health and social assistance providers are the real job creators in our 21 st century economy, and must play a key role in our recovery from recession. What we experienced instead was a tsunami of concern for our more selfish instincts – that w...

When Senator George McGovern, who died this past weekend, decided to run for President, he did so as a World War II hero who opposed the Vietnam War.  A respected South Dakota senator, he helped galvanize anti-war sentiment among young people and ride it to the Democratic Party’s nomination in the summer of 1972. His election prospects that year were as remote as Senator Goldwater’s had been just eight years earlier.  From opposite ends of the philosophical spectrum, there was much to admire about both of them.  But they were also both too removed from the center of the political spectrum to be electable in the moderate America of those times. As a vocal McGovern supporter back in 1972, I have long wondered how he felt about the one thing I admired least about his political career – the moment when he let fear about mental illness alter the course of our public policy history. There is an excellent and recent brief story about this on the National Publ...

When Senator George McGovern, who died this past weekend, decided to run for President, he did so as a World War II hero who opposed the Vietnam War.  A respected South Dakota senator, he helped galvanize anti-war sentiment among young people and ride it to the Democratic Party’s nomination in the summer of 1972. His election prospects that year were as remote as Senator Goldwater’s had been just eight years earlier.  From opposite ends of the philosophical spectrum, there was much to admire about both of them.  But they were also both too removed from the center of the political spectrum to be electable in the moderate America of those times. As a vocal McGovern supporter back in 1972, I have long wondered how he felt about the one thing I admired least about his political career – the moment when he let fear about mental illness alter the course of our public policy history. There is an excellent and recent brief story about this on the National Publ...

Former U.S. Congressman Patrick Kennedy was in South Florida last week pushing the radical idea that all people, including those with mental illness, are created equal. What makes this idea radical in 2012 is that we continue to discriminate against the 6% of Americans who have serious mental illnesses.  Patrick Kennedy understands this, and is devoting his life after Congress to fighting on their behalf. It is a fight that affects him personally, as it does the one-fifth of all children and the one-fourth of all adults with a diagnosable mental illness each year. Discrimination against people with mental illness takes on many forms – arrests for loitering, incarceration instead of treatment, and perhaps most commonly in the unequal coverage by insurers for mental health conditions. This last form of discrimination was supposed to have ended with the passage of the Mental Health Parity and Addiction Equity Act of 2008.  But the federal “rule” implementing t...