In this “How Would You Fix It?” interview, Julie Rovner, KFF Health News’ chief Washington correspondent and host of the What the Health? podcast, sat down with David Blumenthal — a physician, health policy expert, former Obama administration official, and author — to explore the dynamics that make fixing the nation’s health care system so difficult.
They discussed the pivotal role the president of the United States plays in health policy — whether it is building support for or opposition to new plans and proposals. “Presidents have a level of authority which is often underappreciated, especially in health care,” Blumenthal said.
Blumenthal and Rovner also discussed the historical reasons the U.S. has been unable to enact universal health care, incrementalism versus sweeping change, and what he described as “the dance” between proponents and opponents — usually a clear party-line split between Democrats and Republicans — of major health care reforms.
This item summarizes a KFF Health News “How Would You Fix It?” interview in which Julie Rovner, chief Washington correspondent and What the Health?
podcast host, spoke with David Blumenthal, a physician, health policy scholar, former Obama administration official, and author.
The conversation centered on structural and political barriers that have impeded major change in U.S.
health care policy.
Blumenthal emphasized the president’s distinctive capacity to shape health policy debates, arguing that presidential authority in this area is often underestimated.
The president’s role was discussed in terms of its power to mobilize support or opposition for proposals rather than as a technical policymaking mechanism.
The participants reviewed historical factors that have prevented enactment of universal coverage in the United States.
They distinguished between incremental reform strategies and comprehensive overhauls, characterizing the interaction between reform advocates and opponents as a recurring “dance.” This dynamic was portrayed as typically aligning along party lines, with Democrats and Republicans occupying opposing positions on major health policy initiatives.
Blumenthal observed that contemporary polarization has intensified; in his view, one segment of the political landscape increasingly treats public health, scientific expertise, and related institutions as adversarial.
He identified this shift as an additional complication for advancing substantial health system changes.
Although the interview touched on potential paths forward, the summary does not itemize specific policy prescriptions discussed.
The segment referenced an abbreviated broadcast on Episode 443 of What the Health?
and noted Blumenthal’s recent book, coauthored with James A.
Morone, which documents divergent health policy approaches across three presidential administrations.
The source provides a high-level interview synopsis without detailed methods, empirical data, or a complete list of proposed solutions.