A Clear Path?

Today we have heard a variety of opinions from close observers of, and one participant in, the early phases of development of health care reform legislation.


The participant was Neera Tanden.  Ms. Tanden was a senior vice president for Academic Affairs at the Center for American Progress before being appointed Hillary Clinton’s policy director for the 2008 presidential campaign.  Then, late last June, she was recruited to become Director of Domestic Policy for the Obama campaign.  She is now the point person on health reform for the Department of Health and Human Services in the Obama Administration.  After making relatively brief remarks as the luncheon speaker at ACEP’s Leadership & Advocacy Conference, she invited questions.


Most of the questioners focused on enlarging her understanding of the emergency medicine perspective on reform of the health care system.  She did her best to assure us that our concerns were not unfamiliar to policy wonks in the Administration and among the leaders and staffers of key Congressional committees.  And she was forthright in asserting that the Administration has learned from the errors made during past, unsuccessful, efforts at comprehensive reform.  One member of the audience (can you guess who it might have been?) asked if there is reason for us to believe that the president’s “clear path” toward universal coverage does not represent more ineffective incrementalism on a “long and winding road” (apologies to Paul McCartney).  Ms. Tanden was certainly the most optimistic of the speakers who addressed us today, asserting that President Obama did not come to the White House to accomplish small things, that his approach to reform will be bold and aggressive, and that it will be weeks to months, rather than years, before we are firmly on that clear – and short – path toward the goal of covering every American.


An earlier speaker had pegged the likelihood of enacting substantial health care reform legislation this year at no better than 50-50.  Let us hope that Ms. Tanden’s optimism proves to be well founded.  As Mr. Obama has said repeatedly, the cost of inaction is unacceptable, and doing nothing is simply not an option.   

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