Does the election mean that "Reform" is dead?

As the dust begins to settle after the election it is only reasonable to question if the recent reform legislation will be repealed as many of the newly elected legislators have promised. If not repeal then what?

An interesting survey was published a month or so before the election but it didn’t get much visibility. The survey looked at opposition to the healthcare reform legislation and, while it found that a majority of those responding were opposed it went a bit further and found that many of those opposed felt that the law didn’t go far enough. What this means is that there is still significant support for changing the system within which we exist.

So, back to the original question: What will happen? The President has already gone on record of drawing a line on his healthcare initiative, he’s not willing to negotiate reform. We believe that the greatest focus of opposition is the coverage mandate. When you read the law the requirements for small and medium size business are expensive and the alternatives for those covered are not all good. We think that universal coverage will be back on the table.

It appears that the Senate will remain Democratic but there may be some willingness on the part of worried Senators to negotiate some changes with the Republican opposition.

One thing that both consumers and employers can agree on is the cost of care. It is too high (let’s ignore the fact that we are essentially getting what we demand…that’s for another day). As we have stated before this means that costs need to be controlled, which translates to utilization needs to be controlled, which means that Accountable Care is likely to be alive and well. We might see a delay in the Medicare initiatives but we don’t think that incentives for integration of physicians and hospitals will go away.

Approximately 60 House seats have changed hands. This means that there will be a learning curve period as these new folks deal with the fact that they now Chair many of the committees and that they don’t even know how to find the rest rooms. This means a period of inaction for the next six months so don’t look for dramatic shifts in policy or direction. We will likely see a set of proposed regulations, based on the current law, before congress takes up the issue. We can safely assume that many of the provisions of those regulations are DOA but we need to go through the process.

Our basic message is that Integration makes sense. It will drive cost containment and both parties will need to continue to address this issue if they want to get reelected. Don’t lose sight of the need to plan for this and, while we may be more than 24 months away we can expect progress before the next election. We can assume the President likes his job and will keep this before the public.