Health Care System Reform in the Age of Obama


When Barack Obama was elected, I anticipated changes that might be coming with the unease felt by many who are naturally conservative – by which I mean opposed to change merely for the sake of change. But there are clearly some features of our society that are desperately in need of change, and the health care system is one of them.
If you ask a gathering of emergency physicians what is needed in health care system reform, you will discover a wide range of opinion. There are those who favor a single-payer system with the federal government as the payer. Others, of a libertarian bent, believe that is the worst thing we could do, and the focus should be on increasing competition and giving the public a much greater sense of individual personal responsibility for achieving and maintaining health.
The president, his Administration, and the Democratic leadership in Congress all seem to agree that health care is a right to which there should be universal access and for which there should be universal coverage – and that the time is now to move decisively toward making that view a reality. Efforts to achieve that kind of reform have been made several times over the last half century and have repeatedly failed. Many believe the forces aligned in support of such a sea change are now more formidable than ever and that the opposition is weak and scattered. But in a time of economic recession there will be resistance to new, very large, and very expensive government programs. Mustering the national social and political will to make universal access to basic health care an American reality will require inspirational leadership. Obama’s admirers and detractors alike perceive that ability in him. Let us see how he brings it to bear in addressing this pressing social problem.

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