It's a chance to revive reform, but Dems may need to go it alone.
Those wariest of health reform are often those who have health insurance -- the "I've got mine" crowd. The trouble is that many won't have theirs much longer unless meaningful reform happens -- and soon.
That's why the televised health reform summit convened today by President Obama is something more than the latest episode in the soap opera that health care reform has become. Figuring out how to move forward is critical not only to extend coverage to those without, but also to ensure that the 85 percent of the population with insurance can continue to afford it.
The latest warning to the complacently covered came from California insurer Anthem Blue Cross, which just announced that some individual policyholders will see 39 percent rate hikes. That justifiably sparked outrage across the country. But the hefty hikes faced by consumers in California and across the country are only part of the story. Consumers are also continuously required to dig deeper for higher copays and deductibles. In 2002, 9 percent of Minnesotans with individual plans similar to those issued by Anthem had annual deductibles of $3,000 or more. In 2008, it was 26.7 percent.
The health reform plan released by the White House earlier this week is essentially the plan approved by the Senate, but with a few tweaks. Some of the president's proposed changes are good -- increasing subsidies to help the uninsured buy policies. Some are not -- proposing a federal agency to rein in rate hikes is a populist gesture.
Bottom line, the Senate/White House plan is a first step toward reorganizing a vast, expensive system and figuring out how to make it run more efficiently. It makes advances in three major areas: coverage, cost and quality, and contains most of the menu of reforms recommended by experts. It also starts moving away from a system unfairly burdensome to the privately insured, whose premiums are climbing in part because costs from the uninsured and from losses sustained by caring for Medicare and Medicaid patients are often passed along to those who can pay. This cost shifting is an unsustainable hidden tax that those decrying reform's high cost disingenuously fail to acknowledge.
How anyone can deride this plan as "socialism" with a straight face is unclear. The Senate/White House plan melds key elements of Republican Mitt Romney's Massachusetts reforms and changes proposed by Republicans such as former Minnesota Sen. David Durenberger as an alternative to the 1993 Clinton health care plan. It's rooted firmly in the private sector and would open the door for more competition among insurers to lower prices. The proposed exchanges allowing consumers to comparison shop could be a real game changer.
Is there room for improvement? Absolutely. Republicans have some excellent ideas, some of which are already addressed in the bill, such as payment reform and selling insurance across state lines. When GOP leaders propose meaningful malpractice reform at the summit, Obama should say, "Deal." Same goes for measures that enhance consumer choice and those that would stem deficit spending -- such as a tax on employer-provided plans, something John McCain advocated for in his presidential campaign.
A new Kaiser Family Foundation poll suggests that Americans overwhelmingly support key components of health care reform contained in the Senate bill. Fifty-eight percent said they'd be angry or disappointed -- compared with 38 percent who would be relieved or happy -- if Congress stopped working on it. If Republicans don't seize the chance for bipartisanship the summit offers, Democrats need to cease their handwringing and pass the plan on their own. Reconciliation is simply another way to say majority vote.
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