Why Washington Isn't Solving Our Health Care Woes
Aug. 25, 2000 (Washington) -- I predicted at the start of the
year that Congress would not enact any significant health care legislation this
year. While there is still time for Congress to prove me wrong, I think my
prediction will hold up.
The question is, why?
It's not as if our health care system is perfect. The news
wires have been filled this past year with stories about seniors needing help
to pay for prescription drugs, about
people whose HMOs are callous, or about the high number of people without
But from Washington there's only been rhetoric and political
accusations, which will increase as Election Day nears.
In my view, there are three fundamental reasons why the
Republican Congress and the Democratic administration have failed to pass major
health care legislation:
- Political partisanship is at its worst ever. Listen carefully to what the
politicians are saying. They attack each other rather than advance solutions of
their own. Neither party is willing to share with the other -- or with a lame
duck president -- the credit for legislative achievements. There are no leaders
who are willing to set aside partisanship. The Republicans are just as intent
in denying President Clinton a solid legislative legacy as he is in seeking
one. I'm not alone in saying that partisanship in Washington has reached an
- There are too many health care issues that need to be addressed, and
therefore there is no focus. Seniors seek prescription drug coverage under Medicare. The rights of patients and physicians to deal
with the arbitrariness of HMOs needs to be addressed. Medicare needs to be
reformed to reflect current medical practice. We need to make it easier for the
40 million uninsured Americans to get reliable medical treatment, and not just
in emergency rooms.
A survey taken by the Washington Post found that there are six health
care issues on the public's mind, in this order: Medicare financial security,
health insurance for more people, patients' rights under HMOs, helping seniors
pay for medicines, price controls over drugs, and helping care for the
elderly or disabled.
But only 20% of the public believe that the top issue, assuring Medicare's
financial stability, is "most important." Congress can't deal with all
these issues at once, especially when none stands out as most critical, so it's
become paralyzed and unable to do anything. Historically, the smart political
leaders have succeeded by focusing on a single issue at a time. That's not
- The public momentum for change has waned. Even though some political polls
show that prescription drug coverage is a priority for elderly voters and will
be a central issue in some congressional elections, overall the public no
longer regards health care reform as a top government priority. A study
recently published in the journal Health Affairs found that, in April
2000, only 15% of Americans thought health care should be a top government
priority. That compares with 55% 1994. Without public clamor, there is not
enough incentive for Congress to act.