The Heart of Power

I'm reading David Blumenthal and James Morone's wonderful book (The Heart of Power: Health and Politics in the Oval Office) about the health care policies of presidents from FDR to GW Bush.  Each president approached health care and health care reform differently - framed by their own personal experiences, political and ideologic beliefs and the political and economic environment.  The book helps clarify just how hard it was to pass health care reform, however flawed.

The book is organized by presidential term, and I'm midway through the LBJ section now.  LBJ consistently told his aides to stop bothering him with the details and the price tags - and that's why we have Medicare and Medicaid today.

Here's a quote I want to share:

"....the more sophisticated the analysis, the dimmer the political prospects for health reform. Put bluntly, careful budgetary and policy analyses subvert the political prospects of covering more people."

Does this mean that presidents should be blind to the financial implications of expanding coverage?  Absolutely not. However, our enhanced ability to analyze and project hasn't always made it easier for us to move forward.

The managing health care costs indicator will return with the next post.