President Obama’s Healthcare Reform

ABSTRACT

In his February 2009 State of the Union address and Budget Message, President Obama pledged to create roughly 3.5 million new jobs, reduce the number of those without health insurance (a primary cause of social instability), and slash the expected 2010 budget deficit of US$1.17 trillion in half within four years to escape the current economic crisis. The keyword in fulfilling this promise is healthcare reform. This is because healthcare is creating new employment even in this period of economic downturn, and is also the largest item in federal government spending.

Healthcare reform represents the most difficult domestic policy problem in the US. Clinton’s failed attempt at healthcare reform in 1994 has been well-publicized. Obama must address the same healthcare reform issues as Clinton, and under significantly higher constraints. Clinton strived to conduct evaluation through the construction of healthcare networks and accumulation of medical information using innovative ideas, but failed because he lacked the necessary infrastructure.

In the 15 years that followed, integrated healthcare networks (IHN) were created among regional healthcare markets and medical information databases were constructed through the spread of healthcare IT. Healthcare reform in Massachusetts is a success model for reducing the uninsured by making those who are simply piggybacking off the current healthcare system also share the burden. Public opinion that rejects further increases in the uninsured is also mounting. A breakthrough in healthcare reform is therefore expected to be within reach for the Obama Administration.

Injecting financial resources into healthcare and creating new jobs are also necessary to weather the economic crisis in Japan. Establishing a Japanese brand of IHN model districts is an effective way to realize this while also enhancing healthcare productivity and quality.