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We didn't ask for health reform? No way.

Posted by John McDonough  September 1, 2012 07:21 PM

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One of the most gratifying elements of Cong. Paul Ryan's speech last Wednesday accepting the Republican Vice-Presidential nomination was the media's reaction to it. It's rare to see such a broad-based take down of a speech based upon clearly documented distortions. Despite the Romney campaign's assertion that "we're not going let our campaign be dictated by fact checkers," that will be the instinctive reaction to Ryan's pronouncements from now on.

There's one distortion, though, that got less attention and deserves more. It's Ryan's assertion that the Affordable Care Act/ObamaCare is "a new entitlement we didn't even ask for."

Really? Let's consider...

Between 2005 and 2008, these national organizations, among many others, issued solo and collective public calls for comprehensive national health reform to provide universal health insurance coverage, medical delivery system reform to promote quality and efficiency, and effective cost control:

American Medical Association (physicians)
Federation of American Hospitals & Catholic Health Association (hospitals)
AdvaMed (medical device industry)
The Business Roundtable (business)
National Federation of Independent Business (business)
America's Health Insurance Plans (insurance industry)
Pharmaceutical Research and Manufacturers of America (drug industry)

None of these organizations -- or their predecessors -- supported health reform during the Clinton era in 1993-94. By 2009, they were all on board, along with a long list of other national organizations.

During the 2008 presidential campaign, all leading Democratic candidates for president advanced serious proposals for comprehensive health system reform, especially Hillary Clinton, John Edwards, and Barack Obama. In the 2008 general election, the candidate with the most radical comprehensive health insurance proposal was the Republican candidate, John McCain, who proposed eliminating the preferred tax treatment for employer-provided health insurance, creating a structure which would move all Americans to individually-purchased coverage.

What I refer to as the "era of health reform good feeling" lasted well into Barack Obama's first year as president. On March 5, 2009, he hosted a well attended White House health reform summit with 150 lawmakers from both parties, as well as every other key stakeholder interest in American society, including all those listed above. Karen Ignagni, the head of America's Health Insurance Plans, stood up in the summit and said: "We hear the American people about what's not working. We've taken that seriously. You have our commitment to play, to contribute, and to help pass health care reform this year." In this bipartisan room, there was not a single voice saying that the American people were not asking for comprehensive health care reform.

On May 11, 2009, key industry leaders from AdvaMed, AHIP, the American Hospital Association, AMA, PhRMA, and the Service Employees International Union, gathered in the White House to make a dramatic announcement with President Obama: "We will do our part to achieve your administration's goal of decreasing by 1.5 percentage points the annual health care spending growth rate -- saving $2 trillion or more," they wrote.

Beginning in June, 2009, the consensus fell apart. As actual legislation was advanced, and as the new Tea Party reaction gathered steam, doubts rose and the era of health reform good feeling was no more. But -- we didn't ask for it?

No way.

This blog is not written or edited by or the Boston Globe.
The author is solely responsible for the content.

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About the author

John E. McDonough is a professor of practice at the Harvard School of Public Health. He is the author of the book “Inside National Health Reform”, published in 2011 by More »


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