• Editorial

Who will pay and who will say no?

Citation

Kamerow, D. (2009). Who will pay and who will say no? BMJ (Clinical research ed.), 339(7715), b3042. DOI: 10.1136/bmj.b3042

Abstract

We are now in a difficult period in the attempt to reform the healthcare "system" in the United States. Initial optimism has waned, President Obama’s popularity has plummeted, and the doomsayers are hanging the burial crepe. Shades of 1994 (the year of Hillary Clinton’s failed attempt at healthcare reform).

Earlier this year there was unprecedented cooperation not only between Democrats and (some) Republicans but also within the ruling Democratic party. This has now splintered. And most of the powerful special interest groups—doctors, hospitals, big pharma, and the insurance and health plan industry—were on board as well, falling over themselves to make public concessions so as to maintain a place at the negotiating table. But those days of bonhomie are gone.

The problem is that no one is willing to give up much. And no one is willing to admit that someone will have to say no to the sometimes extravagant . . .