Reform's big secret: Health bill's full of GOP ideas
News-Journal editorial
March 5, 2010 12:05 AM 54 Comments Vote 0 Votes
Health care reform would likely have passed months ago. But the mobocracy of Republican-driven town halls and its amplifiers on talk radio and cable television replaced facts with politically motivated fabrications and hypocritical moans over fiscal responsibility. The strategy has been so effective that President Obama, better aware than most of the power of perception over fact, is playing to it. He wrote Republicans a letter this week offering to use four GOP proposals in his version of reform.
If facts still mattered, the letter would be redundant. The supposedly Democratic Senate health care reform bill Obama is modeling his compromise on already incorporates the majority of Republican proposals, demands and, above all, principles. Count the ways, based on the wording of GOP House Minority Leader John Boehner's address on the Republican plan, as posted at the GOP's health care Web site (gop.gov/solutions/healthcare):
"Number one: Let families and businesses buy health insurance across state lines." The Senate bill does that (see Section 1333, "Provisions relating to offering plans in more than one state"). The provision would enable several state to form interstate compacts. Florida, Georgia, Alabama, Mississippi and Louisiana could form one, and individuals and businesses in those states could buy insurance provided in any of those states. The compact would require baseline benefits insurers couldn't undercut, to prevent a race to the bottom.
· "Number two: allow individuals, small businesses, and trade associations to pool together and acquire health insurance at lower prices, the same way large corporations and labor unions do." Done. The Senate bill calls for the creation of insurance exchanges where individuals, small businesses and the rest could pool together to lower costs.
· "Number three: give states the tools to create their own innovative reforms that lower health care costs." That's made explicit by the very generous "Waiver for State Innovation" (section 1302), which allows states to sign out of every aspect of mandated reform if they can provide the same baseline services more cheaply.
· "Number four: end junk lawsuits" and defensive medicine. On Tuesday, Obama agreed to provide $50 million in grants to states willing to test alternatives to medical malpractice claims. That's the four points Boehner is thumping for. He's got them. And there's more that Republicans wanted or agreed to.
Removing the cap on lifetime insurance benefits, forbidding insurers to deny coverage for pre-existing conditions, and forbidding insurers to drop the sick are all bipartisan ideas that are in the bill.
Ensuring that reform is paid for is a bipartisan idea, although a relatively recent one as far as Republicans are concerned. Republicans approved the $500 billion Medicare prescription drug plan during the Bush administration knowing that every cent of the program would add to the deficit. Rediscovering "fiscal responsibility" as a political cudgel the moment Obama stepped into office, Republicans insisted that health reform be paid for. Democrats' bills in the House and Senate complied. In fact, the Senate bill would reduce the deficit by close to $104 billion over 10 years while providing insurance to 30 million people currently uninsured, according to the nonpartisan Congressional Budget Office, which analyzes bills in detail. The Republican proposal would save $68 billion over 10 years, but without reducing the ranks of the uninsured.
And here is the biggest concession of all, granted even before the debate started: The Senate bill is essentially a free-market bill that would build on and vastly expand the existing private insurance system. Democrats junked, without discussion, the single-payer system that most Western countries have successfully adopted to lower costs and ensure universal access to excellent care. Many other provisions in the 2,400-page bill are either word-for-word Republican ideas floated in past years or close replicas of such ideas. ...