Post-Election Results Analysis

I stepped out on a limb last week by analyzing results before the polls closed.  Final tallies confirmed my expectation that the election would not provide any good news for medical care or real health reform.  The outcome brings to mind an ad slogan from the 1950s, trading a headache for an upset stomach.  The future will be painful for anyone awaiting relief from government, even if the source of discomfort is changed.  Here are a few post-election observations offered to stimulate discussion.

• Republicans did not take over Washington, DC.  They only seized the House.  Democrats still control the Senate and White House.  Republican efforts to repeal ObamaCare will be well-publicized, but they will be futile.  Even if Republican “repeal and replace” alternatives (e.g., malpractice reform, interstate sale of health plans, strengthening the doctor-patient relationship, prohibiting taxpayer-funded abortions, etc.) offered any hope of solving cost and quality problems, they have almost no chance of being enacted in the next two years.

• Republicans did take commanding control in a lot of states.  The magnitude of their victories suggests that legislatures and governors will impede (or, in some states, prevent) implementation of reforms delegated to states in the 2010 laws.  The dire economic circumstances of most states increases even further the likelihood that the laws will not be implemented as enacted. 

• The election results were quickly followed by release of the latest economic indicators, which continue to be generally dismal.  Unemployment remained at 9.6%.  Overall consumer purchasing power even deteriorated.  I still cannot see how consumers will be able to afford additional financial burdens forced upon them by the 2010 reforms.  Nothing about ObamaCare or last week’s Republican victories shows how we can avoid the health care “train wreck” that both parties addressed during the 2008 elections.

• Last, and definitely not least, the implementation of health reform will be affected by decisions that must be made sooner rather than later to avoid general economic disaster.  Most new Representatives and Senators won by promising to reduce the deficit and increase jobs.  Most economists (me included) see the choice as reducing the deficit or increasing jobs.  If deficit reduction prevails—the more likely outcome, in my opinion—reductions in federal support for health care will larger and faster than expected.

Last week’s election results make me all the more certain that real reforms are going to come from the private sector—visionary providers, payers, purchasers, and their business partners working together to improve the efficiency and effectiveness of health care in spite of government reforms.  What do you think?  Please comment, particularly if you see any silver linings in dark clouds on the political horizon.  After all, we Chicagoans were so dismayed by this election that most of us only voted once…