What are some healthcare reforms we might see in the early days of the Obama administration?
One near-term effort will be an attempt to expand the State Children’s Health Insurance Program (SCHIP). Obama has already talked about doing that. There will also be early discussions about the concept of comparative effectiveness and how that could help control costs. Senate Finance Committee chairman Max Baucus (D – Mont.) has indicated that a center for comparative effectiveness research should be developed. CER is a way to determine the necessity and cost of clinical decisions. Although I expect to see changes, it will probably be incremental. Healthcare isn’t going to trump the credit markets and the banking industry, or issues like energy independence. But people are not happy with the system we have.
Is healthcare reform just as important at the state level?
The pressures on the states for health reforms are even more intense than at the federal level. There has been a 7.9 percent increase in spending for Medicaid programs, and state tax dollars are increasingly obligated to Medicaid commitments. States are the epicenter for health reforms, but they’re scrambling, engaging in a lot of trial and error.
Is there any future for consumer-driven health plans under Obama?
The role of CDHPs was more significant under the McCain health plan than in Obama’s. I think that with Obama, you’ll see the maintenance of the employer-based system. CDHPs will probably grow at or slightly below the pace of the past three years, but now there is no huge impetus for development of the individual insurance market.