Will 2009 be the year of Health Care Transformation? Will mental health services and substance use treatment and prevention be an integral part of a transformative process? These are questions now being posed as we anticipate the first year of the first term of a new Administration. Many are hopeful that with the same political party in the majority of both Houses of Congress and in charge of the White House, that swift action will be taken to assure more access to quality health care to all Americans. Indeed, President-elect Obama has proposed a plan to increase coverage to more people, address quality concerns and affordability. Earlier this month, the Chairman of the Senate Finance Committee, Senator Max Baucus (Montana-D) released his plan that was described by theWall Street Journal as, “a sweeping proposal to overhaul the health-care system that largely reflects President-elect Obama’s vision, increasing the chances for action next year” (WSJ, November 12, 2008). (More on the Baucus Plan later…) While this all sounds very promising for the health care arena and for Americans who need access to quality health care, there are potential obstacles to putting health care at the top of the list, not the least of which is the economy. What has emerged over the last two to three months is the plummeting health of the U.S. and global economies. This begs that the new Administration and Congress must prioritize its actions to address the credit and economic crises and deal with the realities of diverting more federal dollars to those priorities and having less available for health care reform. Add to that, the looming issues of International challenges (Iraq, Afghanistan, Iran, etc) and the energy crisis, health care could be put on the back burner. This is certainly something to watch and those of us that advocate for health care transformation must be continually diligent in pressing for executive and legislative attention. The good news is there are several reasons we can be realistically hopeful that 2009 will be THE year for health care. My old boss, Tommy Thompson shared his prediction this week that 2009 will be the year for major transformation. He indicated, among other things, that if history is any indication, the first year of a new administration is also ripe for passing and signing landmark legislation and implementing major initiatives. In addition to the reasons mentioned earlier (congressional and administration alignment), the appointment of Tom Daschle as HHS Secretary bodes well, as he has been focused on moving a health care change agenda and was a lead adviser to the President-elect’s campaign. As David Broder pointed out, Senator Daschle would not likely give up a lucrative private sector position, unless he had a certainly that moving a change agenda was priority for the new administration (Washington Post, 11/23/08). It is also well known that Senator Ted Kennedy has health care at the top of his agenda and there is much motivation in the Senate to take action now in order to affirm health care transformation as a legacy for him. So there is good reason to be optimistic. So let’s assume health care transformation will move forward next year. How will mental health services and substance use treatment fare? Here is where we need to be very diligent advocates. Again, we have encouraging indications that behavioral health will be addressed front and center.