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Recession will shape health care, increase government involvement

The chances of health care reform that includes a significant government component get better every day the economy is in recession. Economic uncertainty generates fear, which tends to turn Americans toward government remedies.

Last week's surprisingly bleak unemployment numbers threw a wet blanket on expectations for a quick recovery. Unlike more technical indicators -- trade figures, interest rates, exchange rates, for example - jobless statistics are about people and families.

Every lost job, every layoff, every plant shutdown affects individuals. As more and more workers lose jobs, no neighborhood in the nation -- even in states where unemployment rates are relatively low -- is without a family in or near crisis because of job loss.

And what has become one of the most important elements of a job? Health insurance provided by the employer. Lose the job, lose the insurance, or at least lose the capacity to pay for insurance. More often than not, the entire family is affected because most employer-provided policies have a family coverage option.

The health care debate, therefore, will be driven increasingly by millions of people who have lost their jobs and thus their health coverage.

Since job recovery lags behind overall economic recovery, the unemployment rate likely will top 10 percent and remain in double digits in most states even as the economy bottoms out and begins to recover. In addition, millions more who fear their jobs are at risk will look for a safety net in a health care reform package that includes an affordable public option for health insurance.

Politically, the situation is a winner for President Barack Obama and his allies in Congress. It will be easy for them to make the case that those who characterize government interventionist health care reform as socialism belong to a privileged class; they either can afford their own medical care or are secure in their jobs and health insurance.

But for the family in danger of losing access to the health care system, or has lost it already, arguments about faux socialism or government-run health care mean little.

Whatever hybrid reform emerges from Congress and the administration, the politics of the debate will be fueled by the condition of the economy.

As long as the economy is in the tank, major health care reform with a big government-run feature has a better than even chance of happening.

A recovering economy in which re-employed workers retain health insurance benefits from their employer makes a dominant public option less likely. -- The Forum