Being a futurist is not really about making predictions, but people ask for them anyway.
So here is one: The way things are trending right now, Obama and the Democrats will succeed in getting a reform bill – and it will cost them the Congress in 2010 and possibly the presidency in 2012. Why? Because it will be ineffective at bringing most voters any tangible benefits soon, and ineffective especially at bringing down the cost of health care.
Obama (along with everyone else) repeatedly talks about “affordable” health care. What the bill is most likely to bring is health insurance reform. This is very important, and will bring tangible benefits especially for those who must go without insurance now because they have “pre-existing conditions.” But there is nothing in the bills that are most likely to pass that will really bring down the costs of health care any time soon. Yet the bills demand that the health plans cover many more people, and the providers treat them, while putting in place no mechanisms that would forcefully and quickly control costs – so costs are likely to go up even faster than before.
Despite the many obvious problems with our current health payment system, most voters are already covered, most have not run up huge costs on their insurance, most have never been kicked out of a health plan, most have not been refused for a pre-existing condition – so they will see no benefit, only continually higher costs. Of those who are not covered, 1/3 are working poor, who have decided that they just can’t afford health care – and now they will be forced to buy it, at current market prices, with minimal help from their employers or the government. Another 1/3 are people, mostly young, who could afford it, but have decided they don’t want to, because it does not seem worth the money to them – and now they’ll be forced to. Yet if these continue to be the kind of plans that the industry loves – high-deductible, high co-pay plans, most of the time it will seem to be of no benefit to them.
So the great majority of voters will continue to see higher costs, many will feel forced into a bad deal, and most will see no benefit. There will be an enormous backlash.
The storm that will gather over the next couple of years is going to be greatly exacerbated by this backlash, and providers will come even more under the gun to find ways to control their processes and get their costs in line.