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ALBUQUERQUE — This past week was for health care reform junkies and activists like the first week of April for baseball fanatics — a kind of opening week to the political games, policy debates and maneuvering that are sure to unfold over the summer months.
The Obama administration came out with strong language suggesting that the president wants to see a health care bill in place by this summer in which government plays a large role to ensure that every American has health coverage.
The coming struggle over health care reform will bring to the forefront the seemingly age-old battle lines of government versus market-oriented solutions, but it’s a struggle that now takes place in a new climate compared with earlier efforts.
Surprisingly, the new climate is not necessarily due to the growing ranks of the uninsured, nor is it the result of the latest figures about just how much of our gross domestic product is now spent on health care.
Today, many symbols of free-market capitalism, including leading banks and car companies, are now partly owned by the U.S. government, and that sets up a different landscape for the debate on health care.
Specifically, there’s a sense that government will and must play a larger role in the delivery and financing of health care. Much less pronounced are those scary words (to some) like “socialized medicine” from critics as Obama wrote to Congress that now was the time to develop what he calls a “public health insurance option” to compete with private insurance companies.
We did not hear cries to keep the government out, but rather citizens and politicians alike listening quietly, even curiously, to what such a change in the foundation of health care in this country might look like.
No wonder unions and workers are worried when we start talking about doing away with tax incentives for companies to provide health insurance. No wonder hospitals, insurance and pharmaceutical companies are shaking when they hear that their profits may be determined by more than just the free market. No wonder health care providers and patients are unsure of what this means for them.
But after a moment of pause, this is not unfamiliar territory.
After all, we have already faced the frightening question: Government-aided banking or no banking at all? And another: Government-assisted auto industry or no more Detroit?
It makes sense then that we are willing to listen to a new approach for health care, from the halls of Congress to parades in Albuquerque and pubs in Alamogordo.
And remember that this is not suggesting as radical a change as it might seem. Estimates suggest that in our current health care system up to 60 percent of funds spent on health care are public funds, with that percentage continuing to rise as Medicare and Medicaid costs rise and state safety-net programs like UNM Care, SCHIP and SCI expand to meet the growing need.
What is notable about last week’s movement on health care reform — and even the president’s speech to the American Medical Association earlier today — is that the Obama administration has set down novel ground-rules for this year’s debate. His message is clear — those interested in working on a proposal for health care reform that involves a public health insurance option overseen by the federal government should let their voices be heard.
And until a contingent stronger than the president’s rewrites the rules, this will be the framework for discussion on the issue of health care reform in the coming months.
For New Mexicans, maybe all of this is good news. Despite attempts to change our state’s ailing health care woes — including the nation’s highest percentage of uninsured — the New Mexico Legislature has yet to enact any major pieces of health care reform legislation.
So, as the season begins, expect lots of drama, a few fights, and hopefully a more sane, more affordable, more just health care system for patients and providers when the dust finally settles.
Anthony Fleg, a regular NMI contributor, is a family medicine resident physician at the University of New Mexico and a coordinator for the Native Health Initiative.
