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TOPIC: "Health Reform 2.0" (American Prospect, 8/17/10) "The Next Health-Reform Campaign" (American Prospect, 8/16/10)


Diamond

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"Health Reform 2.0" (American Prospect, 8/17/10) "The Next Health-Reform Campaign" (American Prospect, 8/16/10)
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This is clearly from a progressive source. That said, these are quite informative articles.

Read @ American Prospect (Propect.org)

Health Reform 2.0
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If reform is to succeed, progressives will have to fight for a stronger government role, including a public option.




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Jacob S. Hacker is Stanley Resor Professor of Political Science at Yale University, is the author, with Paul Pierson, of Winner-Take-All Politics: How Washington Made the Rich Richer -- and Turned Its Back on the Middle Class (2010).

Sen. Tom Harkin put the point well when he described the health bill as a "starter home." What Harkin neglected to mention is that the home isn't built yet, and the construction zone is in the path of a hurricane -- the fast-approaching storm of runaway health costs and hard-core conservative opposition.

In the face of these challenges, reformers have three great priorities: implementing the law, protecting and defending it from the already-mounting attacks, and renovating and improving Harkin's "starter home" to make it a sustainable structure. The next health-care battle will require organization, narrative, and strategy at least as much as the last did. And this time, reformers will need to call plainly for a greater government role -- armed, if they take their three big tests seriously, with concrete examples of government getting things right.

Wilbur Cohen, the architect of the last landmark reform law, liked to say that policy is "1 percent inspiration and 99 percent implementation." But Cohen's Medicare was a model of simplicity compared with the current law. To overcome deep-pocketed interests and reassure a skeptical public, Cohen's heirs largely eschewed the simple approach to expanding coverage embodied in Medicare: that is, expanding public insurance. (The big exception, of course, was the public-insurance option, which didn't make it into the law but remains vital.)

Instead, the law is a series of big patches to our patchwork system, and primary responsibility for most of them resides with the states. While the state lawsuits under way are almost certain to crumble, that will not stop states from fumbling the establishment of the exchanges, the regulation of insurers, or the expansion of Medicaid. In many states, the wisest course would be to have the feds take on the difficult task of creating an exchange. But wise advice is not always heeded. Reformers should be pressing state leaders to enlist the assistance of the federal government and to craft cross-state solutions in less populated regions.

Rest assured: Insurers and providers will be doing everything they can to shape what states do. Just because they received major concessions doesn't mean they won't push for even more. Reformers, backed up by the federal government, will need to push back.

Reformers also need to recognize that the polarized partisan battle did not end on the night of March 21. It simply entered a new phase -- from ground warfare to guerilla battle.

Continues @ American Prospect (Propect.org)


Read @ American Prospect (Prospect.org)

The Next Health-Reform Campaign
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Supporters of reform knew they had to battle to get it passed. Now they need to wage another campaign to implement it.


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Paul Starr is co-editor of the Prospect. His newest book is Freedom's Power: The True Force of Liberalism. Click here to read more about Starr.


(Por la versión en español, haga clic aquí)

Carrying out health-care reform presents challenges far beyond those of ordinary legislation or even such landmarks as Social Security and Medicare. After a law establishes a new program, the next steps are usually a bureaucratic process of policy implementation. But the legislation passed by Congress last March, the Patient Protection and Affordable Care Act, will need to run a gauntlet of treacherous hurdles and be politically implemented.

The reforms will have to be defended in two national elections because the major provisions don't go into effect until January 2014. Assuming the law survives national efforts to reverse it, its implementation will also depend on complementary action in all 50 states, including many where Republican leaders have been hostile to the changes, questioned their constitutionality, and enacted measures to nullify the federal reforms. Although the federal courts are unlikely to uphold these challenges, the same states may resist fulfilling the substantial responsibilities that fall to them under the law. And even some supportive state governments may find it challenging to carry out their role despite the ample federal money they stand to receive.

In addition, the reforms need to win not just passive support but active cooperation from employers, insurers, and the public at large in the face of determined opposition to the law and widespread confusion about it. Confidence in the reforms will also have to survive continuing growth in health-care costs that the government has no power to control in the short run.

Continues @ American Prospect (Prospect.org)

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These are important opinion articles - both are well grounded in facts.  Top article  (by Jacob Hacker, dated 8/17/10) summarizes the situation quite well.. so is Clintonesque understandable.

Many wonder why implementation of many parts of this regulation is pushed out to 2014.. and the simple truth IMHO is there is soooo much to implement - so many things to create from ground up - that even 2014 is a humongous challenge... That is IF it is going to be done correct with simplification of the administrative side of health care which is the biggest cost reduction possible.  In the absence of that, we will have fake reform at the systemic level... and the cost of that eventually hits the consumers' pockets in one or more ways.

Honestly, I strongly feel that to get Health Care Reform correct, we really REALLY need Hillary Clinton.

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