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Swing To The Right: How Will The Election Affect Health Reform?

Like Tom Friedman, who lampooned some of this year’s unreasonable campaign rhetoric in a recent column, I, too, would be in favor of reality-based political campaigns, but that seemed to be too much to ask for this year. Instead of truth, we now have truthiness.

The joke news shows (and their joke political rallies) seemed to be more popular than the evening news. (I wish Jon Stewart and his 200,000 fans on the Washington Mall last weekend had stayed home, canvassing for their candidates of choice.) Fact-checkers told us that many political ads this season were in the “barely true” or “pants on fire” zones according to the Truth-O-Meter. But in the end, the buzzwords seem to have worked their magic, and many “insiders” are out, and “outsiders” are in.

The angry and the impatient on the campaign trail have, in some cases, adopted the line from the movie Network: “I’m mad as hell, and I’m not going to take this anymore,” perhaps forgetting that while that line garnered the Howard Beale character strong ratings, network bosses arranged for his on-air assassination when his ratings fell.

The Utopia tune below, “Swing to the Right,” comes to you from the Ronald Reagan era, and perhaps we are seeing the generational swing of the pendulum back to the right. It does seem to happen every 30 years or so. But don’t blame me — I’m from Massachusetts (home to a Democratic sweep on the recent election night).

The last two years have seen a tremendous amount of change in Washington. The question of the moment, of course, is:  How will the election results affect implementation of healthcare reform?

The short answer is that even having sustained the losses that they have, the Democrats in Congress will be able to sustain a Presidential veto of any GOP anti-health reform initiative. The 2012 election may well determine the ultimate course of health reform. If the GOP gains further ground in two years, then implementation may be that much more difficult to accomplish.

For a cogent analysis of the high stakes for health reform in the midterm elections, see Henry Aaron’s recent piece in the New England Journal of Medicine (hat tip: Jane Sarasohn-Kahn, aka @healthythinker).

(As an aside, the challenges to the health insurance mandate pending in courts around the country, of course, also pose a potential threat to health reform implementation. Interestingly, GOP opposition to the health insurance mandate coexists with support for the spread of affordable health insurance for individuals, even though combining the two positions makes no actuarial sense: Without mandate-driven health insurance purchases by Young Invincibles, there can be no “affordable” health insurance for individuals in a community-rated market.)

Stay tuned for the next bit of political theater as the latest “doc fix” expires December 1, and the lame duck Congress decides what to do about the SGR and the nearly 25 percent Medicare physician fee schedule cut that will go into effect unless, once again, there is some last-minute Congressional action.

*This blog post was originally published at HealthBlawg :: David Harlow's Health Care Law Blog*

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