Two Republican Congressman recently wrote an editorial article in the Wall Street Journal on Healthcare (How to Insure Every American 9/5/09) which is representative of their partys members views and really crystallizes some of the problems with the Republican partys positions on Healthcare and reveals that Republicans have critical common ground with Democrats which raises the following question. Why cant there be a bi-partisan healthcare reform bill? Part of the underlying message that Republicans in this article are conveying is that the cost of health insurance is a significant burden on Americans and they really underscore the unfairness in Americas tax system where it gives a Americans with employer provided health insurance a tax benefit, these Americans get to exclude the portion of their income they pay toward health insurance premium from their taxable income, Americans without employer provided health insurance dont get. What is extremely important to note on this matter is that the vast majority of Democrats totally agree with the Republicans on these points. The problem here is that the Republicans overreach in their solution to these problems. The Republicans wrote in this article that their solution is to give these Americans who dont get employer provided health insurance a dollar-for-dollar tax credit for the health insurance premium expense they incur. There are two apparent problems with this solution. First, it doesnt distinguish between wealthy and non-wealthy Americans; the distinction is needed because America has a budget crisis and can neither afford nor is it needed for the U.S. government to fully reimburse wealthy Americans for their health insurance costs. Secondly, with the government fully reimbursing Americans for their health insurance premium costs where is the incentive for these Americans not to buy Cadillac type of health insurance plans (for instance, plans with no or extraordinarily low co-pays or co-insurance provisions) and help hold down the nations overall spending on Healthcare which is a serious problem. If Republicans are really serious about solving this tax code unfairness on health insurance if they really have good faith on this matter they should be able to extract an agreement from the Democrats for the obvious solution on this matter because an abundance of Democrats have publicly acknowledged this tax unfairness how can they reject a good solution to this problem? The obvious solution is to compute the average amount of income that Americans with employer provided health insurance are excluding from their taxable income and allow Americans without employer provided health insurance to exclude from their taxable income the amount of health insurance premiums they pay up to that average amount, this eliminates the disparity in the tax code it eliminates the unfairness! The other major problem these Republican write about in their article is the problem of how to deal with those Americans that have serious health problems which are very costly on insurers. These two Republicans in this article imply the solution and an abundance of other Republicans have explicitly supported the same solution which is they expect states to create high risk pools which either offer affordable health insurance to these Americans or re-insure these individuals, that is reimburse these individuals insures for a substantial portion of the medical claim costs of these individuals. This solution is a joke it is completely absurd. This solution is calling on the states to significantly pay for this problem in providing the funding to pay for these high risk pools. It is absurd because many states cant even afford to adequately fund the health care obligations they already have, how can the Federal government put another such obligation on them? Many states arent meeting their financial obligations to fully fund Medicaid and CHIP programs in their state (e.g. It is estimated Californias failure in funding CHIP results in two million of Californias children not having health insurance). This absurd solution offered by Republicans proves clearly they are not serious about solving the nations health care problems and they dont offer alternative leadership from the Democrats for the American people on Healthcare. One giant ray of hope for political consensus on the healthcare issue is embodied in these Republicans point at the end of their article where they write Those who cannot presently afford coverage would be able to select and purchase their own plan using a health-care voucher provided by the federal government. This solution is in essence exactly the same solution the Democrats have in their healthcare reform proposal, however, they call it the affordability premium credit program. This is a critical consensus because the most valuable, important, vital part of the health care reform legislation is not the exchange idea or the public option or the advisory committees, etc. but rather it is the financial assistance from the government that will enable middle class and low income Americans to be able to afford health insurance that this legislation offers. This bi-partisan consensus should offer hope for forging bi-partisan legislation. One glacial obstruction to passing bi-partisan healthcare reform legislation is how to pay for the legislation. Republicans deserve to be taken out to the woodshed on this issue and given a beating they will never forget because they are totally unreasonable on this issue. Most of the time Republicans completely ignore and/or duck this issue the only real alternative they offer is they say that the government needs to do away with the exclusion on taxable income for premium payments for either employers and/or individual Americans and this will raise all the money that will be needed. There is no doubt this will raise massive sums of money for the U.S. government but there is also no doubt that this will cause a significant number of employers to drop their health insurance plans because it will be too expensive for them if they lose the financial benefit due to the income exclusion on their taxes to pay their insurance premiums. Furthermore, if the American people learned one thing from the extraordinary public debate on healthcare over the last four months is that the American people want the government to do no harm on healthcare matters and the employer provided healthcare system for a massive number of Americans is a good system and these Americans dont want it harmed. For this reason this premium exclusion on taxable income solution is a non-starter. Solving the funding problem by alone cutting Medicare spending is also a non-starter because if Congress publicly decided not to do anything related to healthcare reform for Americans under 55 years of age for the indefinite future they would still have to reform the Medicare program one could give many reasons but enough said that this year the amount of money the U.S. government will take in with respect to Medicare payroll deductions on American workers will not be sufficient to pay the U.S. governments expenses on Medicare and the payment gap will only grow in the future, this situation is unsustainable the U.S. government has to cut Medicare expenses it has no practical choice. The bottom line is that health care reform in America requires additional funding and if the Republicans want to have any credibility on the healthcare reform issue they will recognize this and support fair and balanced revenue raising proposals and this means a tax increase(s). The present healthcare reform legislation in Congress is a disaster, it creates unnecessary bureaucracies and is alarming in its unnecessary expenditures but that doesnt excuse the Republican Party from not being a reasonable and responsible partner for Democrats in solving Americas healthcare crisis. Rank and file Congressional Republicans have to start being independent from their caucus leadership on this issue and start acting like citizen representatives that have good character and good virtue. Otherwise, good mainstream America Republican candidates will take their jobs from them in the future.