Are Political Winds Favoring Real Healthcare Reform?

Philip Betbeze, senior editor, finance , November 5, 2007

The tide on universal healthcare may finally be turning.

Fifteen years ago, most companies received Hillary Clinton's health plan coldly, and it died a quick death. While universal healthcare has always been a liberal cause, some of its erstwhile enemies are beginning to change their attitudes toward any system that removes the burden of paying for their employees' and retirees' healthcare. And if anything moves the needle on a politically polarizing debate like single-payer or universal healthcare, it's when companies that donate to political campaigns and spend millions lobbying Congress begin to back the concept, if not necessarily the specifics.

Companies aren't pinning all their hopes on broad-based national healthcare reform, by any means. Union Pacific, for example, is trying a multitude of strategies to improve the health of its employees and cut costs. The railroad company's CEO, Jim Young, is featured in the "Personalities" section of HealthLeaders magazine this month, discussing the many initiatives his company has in place. But as admirable as many of these strategies are, they're not working fast enough.

That's why you see groups like the Coalition to Advance Healthcare Reform being so vocal. Take a look at their member list, where you see labor unions on the same list as some of the nation's largest companies, like Kraft Inc., UP rival Norfolk Southern Corp., and even medical device makers like Medtronic Inc.--though one wonders why there's such a for-profit healthcare contingent, unless it's to sabotage the whole cost containment drive.

Rest assured, most of these companies aren't doing this out of any sense of altruism. The double-digit annual percentage increase in their healthcare costs, despite their attempts to move more of the burden onto their employees, is hurting their ability to compete--especially overseas, where large corporations don't have to worry about paying for Ernesto's pacemaker or Helga's lap band surgery. Large companies from Safeway to Wal-Mart are joining the debate, offering few specifics except for their demand for a national solution to the problem of the uninsured. That they're doing so while standing arm-in-arm with labor union heads should speak volumes.

While many hospitals and other healthcare providers may believe that universal or single-payer healthcare will solve a lot of complicated problems for them, from bad debt to other uncompensated care, be careful what you wish for. Medicaid doesn't currently pay your costs, and Medicare isn't a whole lot better, from what I hear from you all. You're being kept afloat financially through commercial payers, as much as you hate to admit it.

So don't think that nationalized healthcare is a fait accompli. The way the debate is shaping up, and given the huge variety of players who want a solution but aren't sure how to achieve it, the alliance of ideas could easily falter. Like the famous scene in One Flew Over the Cuckoo's Nest, it could all devolve into a chorus of Cheswicks screaming, "I want something done!"

But compromise is in the air. No one stakeholder in this debate is getting off easy.

Philip Betbeze is finance editor with HealthLeaders magazine. He can be reached at

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