There is both substance and agreement for the parties to unearth.
"An arena for political theater" is what Sen. Judd Gregg, R-N.H., called President Obama's proposed Feb. 25 summit on health policy reform. I agree. But it is the right thing to do.
Recent polls show the dissatisfaction of the American people with polarized politics, the political parties (Republicans more than Democrats) and Congress. Having undertaken the reform task at which no predecessor has been successful, the easier course for the president would be to drop the issue and promise to come back to it.
But all of us who have been at this task before understand three important realities: One, no president who has launched such an effort unsuccessfully has ever been able to relaunch; two, the Senate legislation, at least, has been the product of much bipartisan effort over the last several years, even though no Republican senators voted for it, and three, the status quo costs and quality of this country's health care system are totally unacceptable -- to the health care industry and to those who depend on it.
The many experts on health policy from whom the president is drawing advice for the summit agree that some very good policy legislation has been lost to bad politics and deliberate obfuscation. As a result, people have concluded that while the Republicans may be exaggerating or even lying about the health care bills' content, Democrats can't be trusted to get reform right.
So, there is much for all of us to learn by participating in the summit -- what is actually in the bills, and what alternatives Republicans prefer and why. We also stand to learn how much agreement there already is among members, especially in the Senate -- on issues like enhancing value and quality and reducing medical errors and patient deaths; on changing payment systems to reward performance improvement; on care coordination; on chronic-illness prevention and reversal, and on rewarding healthy lifestyle choices.
We might also learn why health insurance is not always what it claims to be and why the best cost-saving measure of all is not condemnation of the industry but total reform of the rules by which companies play, to introduce genuine competition and informed choice. "Buying across state lines" could just as easily be called "national market rules" by which all health plans compete.
We might also learn how health policy leaders in both parties approach physician payment reform in Medicare, and which payment system reforms will likely improve consistency in value for money in medical services. For each of us, particularly Minnesotans, we might better understand what better role states or regions might play in improving value, since we already know significant disparity in outcomes exists across the country.
What are the challenges facing leadership in the Congress? (Especially the majority Democrats, who have done all the work without any of the credit so far?)
First, Republicans at all levels of government oppose raising any kind of taxes, and you can't expand coverage very much without some tax increases. A majority of Americans seem to agree. Republicans also oppose mandates to own insurance, but these are a prerequisite to the insurance reform that will force insurance companies to price their products competitively.
Second, a majority of Americans right now fear that health reform will raise their costs in order to pay for those of others.
Third, Republicans argue that consumers armed with individual indemnity insurance, financed by tax-free health savings accounts and tax-subsidized risk pools, can force doctors, hospitals and insurance companies to price their products competitively. Experts know this isn't possible.
Republicans should take this opportunity seriously. No matter how they read their health reform fear-mongering this year, Republicans have never been trusted to care as much about equity and justice for all Americans as they do about individual freedom, liberty and personal responsibility. Polls reflect deep concern about health care cost escalation among a large and growing number of middle-class Americans and among employers.
Obama can and will make health policy reform a campaign issue this November -- right about the time of "open enrollment," when employers and employees, senior citizens and people with disabilities are looking at cost increases and benefit cuts in their health insurance. It's not impossible that the president, not GOP candidates, will determine what role success or failure at reform will play in the midterm elections.
Dave Durenberger is a former Republican U.S. senator from Minnesota and chairman of the National Institute of Health Policy.
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