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THE HEALTH REFORM “PARADIGM”

THE HEALTH REFORM “PARADIGM”. (I don’t think that’s a real word.). “PARADIGM” . “A set of assumptions, concepts, values, and practices that constitutes a way of viewing reality for the community that shares them, especially in an intellectual discipline.”

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THE HEALTH REFORM “PARADIGM”

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  1. THE HEALTH REFORM “PARADIGM” (I don’t think that’s a real word.)

  2. “PARADIGM” • “A set of assumptions, concepts, values, and practices that constitutes a way of viewing reality for the community that shares them, especially in an intellectual discipline.” • In heath care, there’s no such thing. Which is rather the problem.

  3. What is health reform? • Health Care: Cost, access, quality. • Politics: The act of getting a bill passed.

  4. The paradox of health reform • Access reform. Obama and Massachusetts. • Cost reform.

  5. 3.7% 2.6% Average Percentage Increase in Health Insurance Premiums Compared to Other Indicators, 1988-2007 *Estimate is statistically different from estimate for the previous year shown (p<.05). No statistical tests are conducted for years prior to 1999. Note: Data on premium increases reflect the cost of health insurance premiums for a family of four. The average premium increase is weighted by covered workers. Source: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 1999-2007; KPMG Survey of Employer-Sponsored Health Benefits, 1993, 1996; The Health Insurance Association of America (HIAA), 1988, 1989, 1990; Bureau of Labor Statistics, Consumer Price Index, U.S. City Average of Annual Inflation (April to April), 1988-2007; Bureau of Labor Statistics, Seasonally Adjusted Data from the Current Employment Statistics Survey, 1988-2007 (April to April).

  6. Ezra Klein’s First Rule of Health Reform • Do Not Screw With What People Have. • The first rule of cost reform: Screw with what people have

  7. POLITICS! • Insurers are not the enemy. Nor are pharmaceutical companies, doctors, device manufacturers, etc. • The Senate in the enemy. Obstruction. A system designed to ensure nothing gets done.

  8. THE PROBLEM OF THE PRESIDENT. • Mandates. • Max Baucus. • FDR, Truman, Johnson, Nixon, Carter, Clinton.

  9. The Problem of Plans • Obama, Clinton, Clinton 1994, Edwards, McCain, Wyden-Bennett, Langevin, New America, CAP, CAF, Hacker, Ezekiel-Fuchs, Massachusetts, EPI, Bush, Cato, Heritage, Ezra Klein, France, Kennedy. • We got plans.

  10. Approach • Policy dogmatists and political agnostics. • We need to be, within reason, political dogmatists and policy agnostics.

  11. The Budget Picture • Health care and the bail out, the deficit, etc. • Access alone becomes tougher. • CBO and Wyden • Back to the paradox. • Which brings us back to the politics.

  12. The “Paradigm.” • Politics.

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