For months, Obama, Pelosi, Reid and Co. have been telling Americans that our nation's health care problems can be solved only by a systemic "overhaul," orchestrated by federal government regulators.
Republicans, who believe that Obamacare-style solutions would smother our health system and saddle businesses and taxpayers with crippling new costs, were pushed out of the process. Democrats accused them of being in the pocket of special interests, and ridiculed them as the party of "no."
But the folks on Main Street USA didn't buy the Democratic line. Now Obamacare barely registers a pulse.
Is the tactic of ignoring and ridiculing Republican ideas dead as well? It should be. There's surprising common ground between the parties, especially on health care goals. We should build on that common ground to enact change that Americans from across the political spectrum agree we need.
Bipartisan reform would have three goals: to lower costs, increase access and give Americans greater control over their health care. But contrary to what Democratic bigwigs have told us, many of the most-effective reforms won't cost taxpayers a dime.
Here are measures we should consider:
•Allow people to buy health insurance across state lines. Right now, health insurance companies are protected from real competition. If you live in Minnesota, you can only buy individual insurance licensed in Minnesota. This keeps costs artificially high and discourages innovation and responsiveness. Allowing portability across state lines would free Americans to purchase just the benefits they want and avoid costly state mandates -- for, say, infertility treatment or massage therapy -- that can price people out of the market. One study has found that 12 million more Americans could purchase coverage if this reform were adopted.
•Give small businesses, the self-employed and others the power to pool their resources to offer health care at lower prices. Today, large corporations can lower health insurance costs by spreading risk over many employees. Other Americans should be able to benefit from similar economies of scale.
An even better alternative might be to allow people to take the money their employer uses to buy health insurance for them -- or their own money -- and purchase a plan of their choice, while receiving the same tax advantage as current employer-based plans.
•Provide health insurance coverage for those who don't have it. Obamacare would expand access by creating a sprawling new government-managed plan, and by dramatically expanding our already broken Medicaid system. We'd do better to encourage Americans to set up health savings accounts and to purchase low-cost, high-deductible health insurance plans to use in conjunction with them. For citizens who need financial assistance, in place of Medicaid we could provide tax credits or federal vouchers that would enable them to buy a policy that meets their needs.
•Increase access and affordability for those with preexisting conditions. Even Americans who are happy with their current coverage fear what might happen if they lose their job or get divorced. The cost of obtaining health insurance can be prohibitive for those with a preexisting condition like breast cancer or heart disease.
Some states -- including Minnesota -- have government-subsidized, "high risk" pools to address this problem. But these programs often have caps on costs or enrollment. Bipartisan health care reform should expand and improve this safety net, or offer alternative approaches such as risk-adjustment or reinsurance to ensure that those with chronic diseases can get affordable coverage.
•Enact medical malpractice reform. Today, runaway medical malpractice litigation needlessly inflates health care costs. Doctors practice "defensive medicine" -- ordering tests or treatments whose primary purpose is to protect them in case of legal action. Some doctors face insurance premiums that total hundreds of thousands of dollars per year, and patients foot the bill. Studies suggest that the cost of defensive medicine may be well in excess of $100 billion each year.
Tort reform could significantly lower health care costs, and wouldn't cost taxpayers a penny. To weed out groundless litigation, we could set up special health courts or impose loser-pay provisions for frivolous suits. We could also encourage states to adopt legislation that would limit noneconomic damages and punitive damages, and allow courts to restrict attorney contingency fees, as Republicans have urged for years.
Reforms like these could ensure that all Americans have health coverage while simultaneously lowering costs and expanding choice. If Democrats are willing to focus on common goals and consider ideas from the other side of the aisle, they may discover that we can achieve the goal that most Americans share -- real, bipartisan health care reform.
Katherine Kersten is a Twin Cities writer and speaker. Reach her at email@example.com.