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Health care reform: what we can do!


Rep. Steve LaTourette speaking on health care (AP Photo/House TV)

In light of tanking poll numbers and popular frustration, expressed most vociferously by Republican Scott Brown's election to the Senate, the health care bills as contrived by Harry Reid, Max Baucus, and Nancy Pelosi are dead.  They were justifiably unpopular, they were bad bills.  The House bill was the bolder of the two but was unpopular at best and at least a little dishonest; its oft-extolled, competition igniting public option merely, as Sens. Ben Nelson (D-NE) and Joe Lieberman (I-CT) stated on numerous occasions, a back-door to a single-payer system.  The Senate bill, even before the Louisiana Purchase and Nebraska Compromise are added to the equation, contains so many little pieces of everything as to amount to absolutely nothing.

In this case it seems that to the American people how the sausage is made is almost as important as the actual sausage.  The public wants reform but doesn’t trust either party to do it right, and with good reason.  The Democrats have shut the Republicans out of the debate almost entirely.  The token few who were included in order to make negotiations appear bipartisan were cut out of the loop the closer the bill came to seeing the floor.  This isn’t totally unfair.  The Democrats do have solid majorities in both houses and don’t think they should have to compromise. 

The Republicans, for their part, have taken the low-road; using every parliamentary procedure available to them to slow the passage of any piece of legislation in an effort to allow popular unrest to marinate and boil over through the media.  Rather than enact an aggressive public relations campaign in favor of an alternative, the actions of the angry mobs of tea partiers were left to speak louder than the words of any of the men and women actually charged with making the policies.

This is no reason, however, for health care reform to die completely.  The vast majority of Americans realize the status quo in health care is inefficient and unsustainable.  The political capital and certainly the desire to pass a more modest package of meaningful reforms still exist in Congress.  But Democrats and Republicans are going to need to compromise here in order to get something that everyone can take credit for.  Here are six simple, popularly defensible ideas that could and should pass Congress this year

  • End the health insurance companies’ anti-trust exemption – The Department of Justice is investigating college football for possible anti-trust violations concerning their playoff system.  And yet there is no serious effort in Congress to prevent insurance companies from controlling 90% or more of a state’s insurance market.  President Obama is correct when he asserts that competition in the industry is a GOOD thing.  So let’s force insurance companies to actually compete for our business.  The only thing preventing this blatantly obvious reform from being enacted is the hundreds of thousands of dollars insurance companies contribute to congressional campaigns.  Ending the anti-trust exemption has the added benefit of being politically popular.  The public doesn’t trust the insurance companies who would be furious if this legislation were passed.
  • Tort reform – I’m typically opposed to legislative intervention in the operation of the judicial system.  Judges, juries, and courts should be empowered to make these kinds of decisions and this is not a silver bullet.  But it will help doctors do their jobs better and cheaper and it should help earn more Republican votes.
  • Expanding coverage – Republicans will need to compromise here.  This is one of those times when a little government involvement will benefit everyone.  Perhaps a legal mandate for coverage with government subsidies to help those who are unable to afford a base-level policy.
  • Prevent insurance companies from denying coverage to applicants with pre-existing conditions – There is no reasonable justification for this practice and health insurance companies should be ashamed of themselves for telling people with health conditions that they’re unfit to pay for coverage.
  • Allow individuals and businesses to shop across state lines for cheaper policies – This will force states to provide a regulatory environment in which they have to compete with each other to keep health insurance business local.
  • Invest a substantial amount in better medical IT – Stop duplicating tests.  It’s unnecessarily expensive for patients and what is unnecessarily expensive for patients becomes costly for doctors and what is costly for doctors becomes unnecessarily expensive for people who are still able to afford their medical care and insurance.

This list is not exclusive nor exhaustive.  Democrats will certainly want a more comprehensive bill and have earned the right, electorally speaking, to perhaps go for a little more.  But each of these issues is easy to explain to voters and is hard to be against, should Congressional Republicans decide to be unsupportive.

The kind of bipartisanship that is needed to pass this bill can only be achieved through the president’s leadership.  Speaker Pelosi does not share President Obama’s vision of a grand bipartisan compromise so he must be the one to make this deal.  Though his stores of political capital are considerably emptier than they were a year ago, he remains vastly more popular than Congress and he is still the leader of the Democratic Party.  With a little leadership from the president and some compromise in congress, something good can actually come out of the mess that health care has become.


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