Make no mistake about it; the Obama Administration gets it! Without reform, including cost containment, health care will grow from 16 percent of our nation’s gross domestic product to 25 percent over the next 15 years.This makes reforming health care an integral part of our nation’s economic revival effort.To help expand coverage to more uninsured Americans and as a tool to help bring the annual rise in health care costs down from an average of 6.7 percent to 5.2 percent, President Obama included cost-cutting provisions in his first budget proposal and he wants Congress to include a lower-cost public (government) plan as a competitive option to private health plans in the bill crafted for his approval. Many health industry observers believe the latter is a veiled, back-door effort to move our market-driven, pluralistic health insurance system to a more controversial, government-run, single payer health insurance program.

Further underscoring their keen policy intellect, the economic stimulus package the administration marshaled through Congress included $19 billion to fertilize the development and spread of interoperable health care information systems throughout the country. Also included was $1.1 billion to fund research to compare the effectiveness of different treatments for the same illness. Both tactics have significant cost containment potential, but the latter may do more to make health care delivery more efficient because it will alter medical practice patterns throughout the country by guiding doctors away from the use of costly, ineffective treatments.

The strategists in the Obama Administration also are scholars of history as well. They learned what not to do from the Clinton Administration’s failed attempt to reform health care in the early nineties. Two key lessons learned were (a) already-insured middle class Americans must buy into the need and sense of urgency for overhauling our existing system and (b) reform proposals must allow consumers to keep the health insurance plans they have if the authors want or need their support. Former President Clinton’s strategists either discounted or did not see the importance of meeting these needs. As a result, the health insurance industry was able to turn off public support for national health care reform with a media campaign that pandered to middle class America’s basic fear and distrust of government. (Remember Harry and Louise?)

We have an elephant in the room, though, that demands equal if not greater attention than reforming health care. Two years from now, almost 10,000 Americans will turn 65 each and every day until by 2030 the percentage of the U.S. population 65 and older is almost double what it was in 2000. If the Obama Administration and Congress fail to restructure or refinance Medicare, the principal program insuring the medical needs of America’s seniors will go broke by 2017, less than half-way through this time line, say officials at the federal Centers for Medicare and Medicaid Services. The administration and Congress need to change this elephant’s diet now or start planning its funeral.

Your thoughts?