EDITORIAL - The struggle for reform - challenges and hopes for comprehensive health care legislation

[Guest guest]

The New England Journal of Medicine

Volume 360:1693-1695 April 23, 2009 Number 17

K. Iglehart

The Struggle for Reform — Challenges and Hopes for Comprehensive

Health Care Legislation

Undaunted by a soaring federal deficit, competing legislative

priorities, and skeptical Republicans, leading Democrats are

relentlessly pursuing health care reform, as they hold hearings,

engage key stakeholders, plot strategy, and draft legislation. Five

congressional committees — two in the Senate and three in the House —

are at work on major reform legislation. While underscoring his

administration's strong support for reform, President Barack Obama has

emphasized his preference that Congress lead in crafting a measure

aimed at expanding coverage, improving care delivery, and constraining

the growth of health care spending.

None of the committee chairs have introduced reform bills yet, but all

have set ambitious timetables that would place an enacted measure on

Obama's desk before the end of the year. The three House committees,

each with jurisdiction over some portion of the health care system and

chaired by a liberal Democrat, are Education and Labor, chaired by

of California; Energy and Commerce, chaired by Henry

Waxman of California; and Ways and Means, chaired by Rangel of

New York. The two Senate panels are the Finance Committee, chaired by

moderate Democrat Max Baucus of Montana, and the Health, Education,

Labor, and Pensions Committee, chaired by the more liberal

Kennedy of Massachusetts.

Though the devil is in the details, the outlines of a proposal that

could attract the support of a sizable majority of Democrats are

emerging. Although each panel focuses on the issues within its

jurisdiction, there is a strong sentiment among Democrats that the

prospects of enacting a reform bill would increase if they could agree

on an approach. The three House chairs underscored this goal in a

March 11 letter to Obama, pledging to " bring similar legislation

before our committees and to work from a harmonized approach to ensure

success. "

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Read the full editorial here:

http://content.nejm.org/cgi/content/full/360/17/1693

Not an MD