Head cracking time on health care reform

It's head cracking time, with opponents of reform reduced to the role of spectators and the majority pulling out all the stops to get a bill passed.

That may indeed include budget reconciliation, a process requiring a simple majority vote that was used early this decade by President Bush and Republican leaders to push through tax cuts.

Pundits will talk today about whip counts, or Keith Olbermann's testimony, but the most important event of the week may be the release of a book, Health Care Will Not Reform Itself, by George Halvorson (above, from Thehealthcareblog.)

The book is important because the author is CEO of Kaiser Permanente, a major player in the current insurance market. Halvorson comes out this week as a proponent of reform, predicting a bill will pass and saying the industry can live with that.

Halvorson's view is that the cost curve can be bent if we better manage chronic conditions like diabetes, which costs $218 billion to manage today. Data and intervention on those with "pre-diabetes" can extend lives at lower cost, he believes.

Many elements of reform are already baked into the system, Halvorson adds. The HITECH bill will lead to data that identifies people at risk. A more holistic payment system, in which even the healthy participate and thus get needed wellness services, will also help, he says.

Despite the elevated political temperature the health reform debate has always been a negotiation between the buyers and sellers of health care services. With a seller saying a reasonable deal is available, the push by big business buyers for a better deal can move ahead.

And I can get back to writing about tech.