Is health reform really dead?

In some circles, we’re hearing that, in the wake of the stunning Massachusetts special election last week, health reform (aka Obamacare) is officially dead.  Obamacare may be struggling, but health reform is far, far from over.  Four main reasons:

1. Many states have put local reform, including needed payment reform, initiatives on hold, pending the outcome of the national debate.  Those efforts, including here in Massachusetts, may pick up where they left off now that the future of a national program is in question.
2. Parliamentary acrobatics are still possible as persistent Reps and Senators, along with a President who may adopt an I-know-what’s-best-and-let’s-not-overreact-to-what-happened-in-Massachusetts approach as opposed to an I’ve-learned-and-grown-and-will-now-adapt approach, may still try to salvage a blockbuster deal.
3. Republicans and Democrats may decide it’s in the best interests of the country to proceed, albeit more systematically and incrementally and in a bipartisan manner.
   
   … and here’s the most important one of all…
   
4. The health care provider industry, already moving down a path toward creating accountable care organizations and medical homes, embracing pay-for-performance programs and contending with data that suggest major gaps in the continuum of care and impending shortages of primary care physicians, are moving in this direction anyways.  Many of the benefits (excluding insurance reform) of the House and Senate bills are already inherent in the initiatives of some of the most innovative players in the market.  With the bright light of the national debate possibly dimming, the quiet laboratories that exist in local markets will begin to kick up their activity level.

Reform isn’t dead.  It’s still coming…