Polly Webster is a health policy expert in APCO’s Washington, D.C. office.
Over the past month, pundits have speculated insatiably about the Supreme Court’s upcoming decision on health care reform. If the mandate or the entire law falls, there will be tremendous uncertainty about which direction our health system is headed moving forward. How will we expand coverage to the uninsured? How will we contain ever-increasing costs? The answers to these questions will have serious implications for both the future of the health system and—in many people’s minds—the future of the nation itself.
The prospect of going back to the drawing board on health reform is striking fear into the hearts of the health policy community. It may be more difficult than ever to make legislative progress against fixing our dysfunctional system. The game has changed significantly since the 2009 debates on the Affordable Care Act. We are now working against more than two years of intense public dialogue and political hyperbole about health policy. Positions on health reform have become a core part of how the public has defined our presidential candidates and the political parties in the face of the 2012 elections. Lines in the sand have already been drawn. Should the Court strike down the mandate and/or other components of the law, the likely outcome will be political gridlock.
But there is something bigger than even the elections standing in the way of meaningful reform if the Supreme Court overturns the law. If we can’t make progress against our health care problems, America’s poor health is bound to hold the country back in terms of our ability to compete on the global stage. For many Americans, our perceived decline in economic prowess is a cause of great anxiety. We’ve already seen this narrative play out in the context of the deficit reduction debate. And like that debate, what really drives the health reform debate is a difference in opinion about what role the government should play in helping us achieve a mutual end goal: affordable and accessible health care.
With this backdrop in mind, many stakeholders are wondering how to cut through the rhetoric and facilitate forward motion among policy-makers following the Court’s decision. History informs us that approaching policy-makers with evidence that the system is desperately broken and pleas for help in fixing it are not enough to transcend the politics that engulf this issue. This was essentially the tone of the debate on the Affordable Care Act. While these messages are powerful and may have enabled legislation to pass in 2010, similar tactics will not be enough to overcome the mounting political barriers that face us now. We cannot re-hash yesterday’s debate.
A more effective communication strategy would be to reinforce the crucial link between the functionality of our health system and the future prosperity of the nation itself. Health care is connected to job creation, workforce productivity and general cost burdens for both employers and everyday citizens. These will be central themes throughout the 2012 elections, and should therefore resonate with both policy-makers and voters. And while members of Congress will almost certainly not agree on what the federal government’s role should be in improving the system, they also will not want to sit on the sideline while their peers work proactively to resolve a matter that so clearly holds the nation back from reaching its full potential.
If we learned anything from our experience in 2010, it should be that on matters of health reform, the war is won and lost in the messaging. If making meaningful progress against our health care challenges is inextricably linked to providing a more promising future for America itself, then anything that holds us back from resolving those issues also limits our future standing as a global leader. And under that scenario—where American exceptionalism is jeopardized—inaction is simply not an option.