Economics analyst David Leonhardt lays out very clearly what we can expect from tomorrow's health care reform meeting at the White House.
For a start, yes, the meeting is largely for show.
There will be lots of preening about who is less partisan. But driving the two sides’ behavior more than any policy details is this: The White House and many Democrats really want a major bill to pass, and the Republicans really don’t. A bill would snatch victory from defeat for Mr. Obama, and it would be a victory that eluded Bill Clinton, Richard Nixon and Harry Truman. No bill would make the Democrats look incompetent.
Leonhardt demolishes the cherished myths on both sides. Of course, it's a matter of whether both sides going into that meeting tomorrow are willing to recognize that they (and the rest of us) have been clinging to those myths as weapons in a very partisan atmosphere. Time to put down the weapons.
What myths? Well, from the Democrats exaggerations about the extent to which businesses have been complaining about health care costs:
That’s mostly a sound bite, as the last year has showed. Companies care about how much total compensation they pay. Rising health costs generally come out of worker incomes, not company profits. If health costs were killing businesses, don’t you think businesses would have lobbied for measures to reduce costs? Instead, they have been silent or even opposed. The fact is, any major change to the health care status quo is scary. We all tend to focus more on what might be worse than what might be better.
Meanwhile, the Republicans hold tight to the fantasy that they know best how to control costs. That's a laugh!
The Congressional Budget Office has estimated that the House Republicans’ health plan would cover three million people over the next decade and reduce the deficit by $68 billion. Expect the Democrats to note that both the House and Senate bills would cover more than 30 million people and reduce the deficit by about $100 billion.The Republicans' stance has been largely partisan and political and less ideological. Track recent Republican administrations. Actual expansion of government by Republicans defeats any notion that their opposition to health care reform is based on their fear of "big government." Not a leg to stand on there.
But once Republicans have stopped their pissing and moaning, there are some good bipartisan compromises that could be made. After all, not allowing either side to "win" anything is getting us nowhere.
So the question is, what could be achieved without actual rioting and bloodshed during and after the meeting?
Let’s agree that a bill should cover millions of uninsured — a Democratic priority — but do so largely through private insurers — a Republican principle. Then let’s say that the bill should reduce the growth of health costs, so our grandchildren aren’t spending half their income on Medicare taxes.
That suggests a bill requiring people to have insurance (to prevent freeloading), regulating insurers (to prevent them from cherry-picking the healthy), subsidizing coverage for the uninsured and small businesses and including no new government-run insurance program. All this describes the current Obama plan and the bills that have passed the House and Senate.They are far from radical, but they do lean left. And they would benefit from a few more conservative ideas. Specialized health courts could introduce more sanity to the malpractice process. Competitive bidding could become a bigger part of Medicare. Government subsidies for the costliest insurance plans could be cut immediately — not in 2018, as Mr. Obama has proposed.
One more thing: I’m not sure whether paying hospitals for good care, instead of more care, is a conservative idea. Republicans have blasted the Democrats’ proposals for doing precisely that. But Newt Gingrich and Bill Frist, former Republican leaders, are right that the bills don’t go far enough. A compromise plan could.
