'Big and bold changes' coming? Well, this could get interesting

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John O'Connor
John O'Connor

The new boss at Health and Human Services is on a mission.

Tuesday, Alex Azar told subordinates that he fully backs President Donald Trump's directive to do “very big and bold things” to our nation's healthcare system.

During a live-streamed, all-staff meeting at the Centers for Medicare & Medicaid Services, he clarified what that means:

“Do the right things, solve big problems and come up with big solutions,” he explained. During a short question-and-answer session, he laid on some context. His four main goals will be reducing drug prices, making private insurance more affordable/accessible, restructuring payments to providers to better reflect quality and tackling an ongoing opioid-drug epidemic. Changes in any of these areas are likely to affect senior living operators one way or the other.

Can't argue with those objectives. And I wish him well. Lord knows, he's certainly in a position to enact major change. After all, his department now oversees the way more than $1 trillion in healthcare dollars are spent each year.

But it's one thing to talk about enacting big and bold change. It's quite another to do it. And it's another thing altogether to have those changes last. At least, that would appear to be the lesson of various attempts to revamp our nation's healthcare system during the past quarter century.

As some of you may remember, President Bill Clinton made healthcare reform one of the top goals of his 1992 campaign. Once in office, he put his wife, Hillary, in charge of making that happen. And for better or worse, she came pretty close. But in the end, the plan didn't have enough votes and quietly died in congressional committee.

President Barack Obama had a bit more luck. He actually succeeded in getting a healthcare reform bill passed in 2010. And it even narrowly survived a challenge that reached the Supreme Court five years later, thanks to the unlikely and unexpected support of Chief Justice John Roberts.

Technically, Obamacare remains the law of the land. But some of its key elements have been stripped away. And by all accounts, there will be more where that came from.

So good luck, Mr. Azar. Enacting new changes won't be easy. As for getting them to remain in place once the other side takes over? Well, that may be just about impossible.

John O'Connor is editorial director of McKnight's Senior Living. Email him at john.oconnor@mcknights.com.

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