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Health Care and the 2008 Presidential Elections: A Window of Opportunity

Confusion about health care is not limited to the complex terminology involved, but extends to the strategies needed to achieve access to quality health care for all Americans.
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Confused? If so, you are not alone. Confusion about health care is not limited to the complex terminology involved, but extends to the strategies needed to achieve access to quality health care for all Americans. With the 2006 elections behind us and the 2008 Presidential elections rapidly approaching, there is a clear window of opportunity to translate and innovate the myriad health care reform models proposed over the years into meaningful, life-saving actions as Presidential candidates put forth their policies and voters go to the polls. Windows of opportunity come rarely, and one is now opening wide with the new Congress in 2007 and the upcoming Presidential elections in 2008.

The next President will confront major health policy decisions that will affect the lives of almost all Americans. Ralph Waldo Emerson once said, "The first wealth is health." The American public has the right to know how the next President will address their health care needs from increasing access to quality health care, to accelerating scientific advances to find cures for the diseases that affect us, to emphasizing prevention to improve the quality of life and decrease health care costs. Now is the time to translate what is known from evidenced based research into innovative solutions to meet the health care challenges and opportunities ahead.

A recent Kaiser Family Foundation's health poll revealed that 46% of voters are "very worried" about health care. Despite this demonstrable concern, only 8% identified health as one of their two top "issues" in deciding their vote in the 2006 Congressional elections. Now it is up to the Presidential candidates, the new Congress and the American public to bring health care concerns to the forefront, and engage in meaningful dialogue about various proposals to provide quality health care to all Americans.

Consider this: America spends twice as much on health care as any other nation - $1.8 trillion -which is 16% of our country's GDP- yet according to a recent Rand Report, we get the right treatment only 55% of the time. Additionally, the United States ranks 18th on life expectancy, 35th on a World Health Organization ranking of the health status of nations, and has the second highest newborn death rate in the industrialized world.

The Federal government currently spends more on health care than on Social Security and national defense combined, the next most expensive items. Expenditures on health care in the United States--already the highest per person in the world-- are predicted to nearly double by 2016, to $4.1 trillion. By the year 2030, with the aging of the Baby Boom generation, seniors over the age of 65 will double to 71 million, increasing health care spending in the United States by 25 percent, if individuals, health care providers and public policies don't take the steps necessary to prevent chronic diseases from taking their toll.

Furthermore, with 46.6 million Americans -1 in 6 people in our country--without health insurance, millions more with minimal coverage, health insurance premiums rising faster than earnings and inflation, soaring costs of prescription drugs (with $200 billion spent on medications last year alone), and the burden of these rising costs on employers, it is urgent that we develop a strategy to improve our nation's health. Pressure is already bubbling up from the States that are becoming incubators for innovative plans to make health insurance available and affordable to their residents. These state programs as well as plans being offered by Members of Congress and the 2008 Presidential candidates is resulting in another great debate on health reform in our country with a menu of different approaches being proposed including: 1) opening up the Federal Employees Health Benefits Plan (FEHBP) to more individuals; 2) encouraging states to develop innovative experiments in coverage; 3) giving tax incentives to help individuals buy their own policies and to assist small businesses purchase insurance for their employees; 4) establishing mandates for individual health insurance coverage; and 5) providing universal coverage by establishing a new plan or by expanding existing government programs such as Medicare and Medicaid to cover many more people.

The Center for the Study of the Presidency (CSP), a non-partisan, non-profit organization has been working to find a path forward by making health care a critical national policy issue in the 2008 Presidential elections and for the next Administration. A key initiative of CSP under my direction, Health Agenda 2008, addresses the suite of health care concerns - soaring medical costs, uninsured citizens, the need to protect against and respond to national disasters, pandemics and possible bioterrorist threats, to emphasize prevention and preparedness, to strengthen health-related research, to eliminate disparities, to apply health information technology to decrease the large number of medical errors that occur in our country as well as to create a more seamless system of care, to improve the delivery of quality medical and public health services, and to increase investments in global health - issues that must be at the top of Presidential candidates' lists. Cross-cutting over forty Federal agencies, these concerns underscore that strong leadership in the White House, in governmental organizations and in Congress on science, health, and technology are more important than ever.

Utilizing a model that the Center for the Study of the Presidency first developed to help in the launching of the department of Homeland Security, CSP will convene a wide range of experts from the health community, Nobel Laureates, public policy organizations, academia and current as well as former government officials for frank, off-the-record discussions of each of the health care issues identified above. These sessions and conferences will produce one or more briefing papers that describe the nature of the challenge, set forth various policy options and the resources required to pursue each, and explain why Presidential action is critical to overcoming the national health vulnerability. A national conference will then be convened to examine lessons learned from previous Administrations and to gather broad input across expertise and geographic regions of the country. A national poll will be conducted of public and health care providers' attitudes, hopes and expectations for health care in the next Administration.

Findings from the poll and recommendations from the working sessions and the national conference, summarized in an Executive Report, will build common ground among the participants, contribute to framing the Presidential debates on science, health and technology issues, and enable the next Administration in 2009 to begin its policy deliberations with a set of issues, strategies, and innovative solutions to accelerate progress on health, science and medicine in the United States and globally. The Center for the Study of the Presidency looks forward to working with a broad spectrum of committed and concerned organizations and individuals to effectively address these issues. We must be the generation that ensures a healthier future for all Americans in the 21st century.