Whether reveling in victory or agonizing in defeat, if you thought we'd have a hiatus between now and the inauguration you've likely come to your senses. Obama will be pursued like no other president-elect before to provide immediate policy for our multiple problems, particularly the economy. In addition to a lame duck, we now have a duckling. As Reid and Pelosi dip their toes reluctantly into the economic mess, a bailout seems in the works for the auto makers. But the question is whether Paulson/ Bush will support one, and more specifically one that Obama - through Reid and Pelosi- may tie to developing vehicles with greater fuel efficiency and reducing layoffs. Outcome based bailouts? Obama is smart enough to use the immediate crisis in this industry to drive forth programs that fit his strategic environmental and social agendas, particularly with Bush feeling legacy pressure.
What might this mean for Healthcare? Although we are seeing health insurance demand greater accountability and experimenting at the margins with patient results, it is still a system that primarily rewards visits and procedures rather than outcomes. Some have said healthcare reform will take a backseat to the economy. But I suspect within the first several weeks of the new Obama administration he will move forward with a program for universal healthcare- even offering it as a means of creating jobs and helping a struggling economy. But will he provide a blank check to the existing structure by enrolling millions of uninsured-one way or the other- into what many believe is an increasingly expensive, broken system? Or will Obama leverage the economic crisis and demand for universal healthcare to create a path for substantial change in the delivery of care and payment methodology. Watch the auto industry for clues as to how sharp his elbows will be on the Healthcare court.
Doctor Steve
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