As 1999 drew to a close, health care was on life support. Congress was at an impasse over allowing patients to sue their health-maintenance organizations and reforming Medicare. And while lawmakers in both parties deplored the plight of the 44 million uninsured, no one was doing anything about it. Meanwhile, a Presidential election season was kicking into high gear, leaving Washington little time or political will to tackle health care.
What a difference a month--and a flurry of public-opinion polling--can make. As Congress returned to work on Jan. 24, health care leaped to the top of the agenda. House Majority Leader Dick Armey (R-Tex.) is predicting that a patients'-rights measure will land on President Clinton's desk by spring. House Republicans are planning to give prescription-drug benefits to low-income seniors, and they promise to beef up medical privacy protection. On Jan. 19, Clinton previewed a hallmark of his Jan. 27 State of the Union Address: a massive $110 billion, 10-year plan to expand health-care coverage for the uninsured.
Why the sudden interest? One factor is the high visibility that Democratic Presidential candidates Al Gore and Bill Bradley are giving the issue. While voter unhappiness had been building for years, Hill Republicans weren't spurred to action until pollsters warned that they may pay a steep price come November. "Republicans are beginning to recognize that they can't be silent on health care," says Scott Reed, chairman of the Republican Leadership Coalition, a group formed to woo minorities to the GOP. Another reason: the hot economy. With a projected $1.9 trillion surplus over 10 years, pols are betting that generosity is a suresfire way to win votes.
A Jan. 19 poll by the Kaiser Family Foundation and the Harvard School of Public Health found that 54% of voters want the government to spend part of the surplus on seniors' prescription drugs. The same percentage said Medicare was a top priority. "There's a resurgent interest in health," says Kaiser Foundation President Drew E. Altman.
Now, health-care companies, like some Republicans on the Hill, are backing off their hard line. The drug industry promises to work with Clinton on a prescription-drug benefit for seniors. And on Jan. 19, the Health Insurance Association of America (HIAA) resurrected the famous TV duo of Harry and Louise, who helped kill Clinton's 1992 health-care plan. Only this time, Harry and Louise are bemoaning the plight of the uninsured--in part to mute the call for HMO reform. "By 2001, it's a sure thing something will happen," predicts HIAA President Charles N. Kahn III.
FALLOUT CONTROL. Meanwhile, chief executives at 15 of the nation's largest managed-care outfits have been meeting regularly since last fall to explore ways to improve their companies' battered image. They are considering a $30 million to $40 million campaign that will paint a kinder, gentler insurance industry--and help limit fallout if a patients'-rights bill passes. "You need to have public approval and public trust," says Roger Bolton, a senior vice-president at Aetna Inc.
The first item on Congress' health-care agenda should be the patients' bill of rights. The sticking point--whether to let patients sue their HMOs--is likely to be resolved by allowing some access to federal courts for patients' grievances. And the Hill next may find a way to provide a limited Medicare drug benefit. While Clinton's proposal to provide coverage to the uninsured is the least likely to see action this year, who knows? Other health-care measures are making miraculous recoveries.