The Bipartisan Health Care Mirage
Posted on March 18, 2010I had a brief chat with Dennis Kucinich and his wife last night at the Radio Television Correspondents Dinner. While I rarely agree with Mr. Kucinich, I think he is very nice, very intellectually consistent, and a very passionate promoter of his ideals.
We talked about the pressures that the Democrats were under to vote for the health care bill that came from the White House. We didn’t talk about the pressure to vote against it that is coming from the American people.
Now, I imagine that Kucinich didn’t get as much pressure from his constituents to vote against it, being that his district is pretty liberal. So, I had always assumed that he would be voting for it, which of course, he is going to be doing.
Obviously, neither the New York Times nor the Washington Post made that same assumption, because they put his “decision” to vote for the Senate bill and the reconciliation side care on the front pages of their respective papers, in the apparent attempt to show that the President has some real “Joe-mentum” as Joe Lieberman might put it.
Well, if it is taking this long for the President to get Dennis Kucinich, I am not sure that is a good sign for the White House efforts.
I have no idea if the Democrats are going to be able to get to 216 votes so they can pass this health care bill. But I do know that it is unlikely that they will get to 218 or 220 votes, nor will they get to 250 or 270 votes.
The conventional wisdom has been and continues to be that the Democrats will pass this legislation because they simply have no choice. But every step they take to get this done only seems to get them in deeper mud. For example, Pelosi’s effort to avoid a direct vote on the Senate health care bill has turned out to be a complete blunder. The populist backlash has been intense, and it will probably make it even more difficult for her to round up the votes.
All of this begs the question, why did it have to be this way? Couldn’t there have been a bipartisan health care approach that would have been more centrist in its approach and less expensive in is cost?
Doug Holtz-Eakin asked that very question this morning as a meeting he put together, which included Senator Orrin Hatch and heath care experts and economists. Holtz-Eakin is the President of the American Action Forum, and the Forum included presentations by business leader Foster Friess and economist Joe Minarik, from the Committee for Economic Development.
Hatch noted, in his opening remarks, that usually, when the Senate works on legislation with wide social welfare implications, it votes with a broad array of bipartisan votes. Medicare, welfare reform, and the S-Chip bill, (with which Hatch was a key player) all passed with more than 75 votes. Not so with this health care bill, which will be lucky to get more than 55 votes.
Foster Friess takes a businessman’s approach to health care. For him, the biggest problem in health care is cost, and the best way to limit cost is to give consumers more power. He favors policies that give individuals control over their health care insurance through health savings accounts. This includes a mandate that will allow health care providers to make available the costs and the results of their health care services; give those without employer paid health care the same benefit of purchasing health care with pre-tax dollars (Contributions to his or her HSA or to an individual plan of up to $7,500 per person or $15,000 per family may be deducted from taxes); and increase the risk pools so that consumers can purchase simple health insurance policies across state lines without expensive mandates.
Friess makes the important distinction between pre-paid health care and health insurance. Pre-paid health care means that you will pay a higher premium, but you get everything taken care of by the insurance plan. A real insurance program means insurance against the risk of catastrophic illness. You can manage the costs of a real insurance program. You can’t manage the cost of a health care system that promises everything for free.
Minarik envisions a much bigger role for the government. His organization calls for the creation of a national system of health insurance exchanges, under the supervision of a new agency patterned on the Federal Reserve Board, which he calls the “Health Fed.” He also calls for the “Health Fed” to regulate regional differences and eliminate conflicts between state and federal regulation of health insurance agencies. He also wants to create a create a national institute for medical outcomes and technology assessment to help measure and determine the effectiveness of new technology and procedures in the delivery of health care.
Clearly, Minarik and Friess have different ideas on how to fix health care, but none of those ideas are being included in the current bills that are facing such fierce resistance from the American people.
In his opening remarks, Holtz-Eakin said that at the beginning of last year, he had hoped that the Democrats were going to proceed with a bipartisan approach to health care, and that he was ready to work hard to make it happen. As has become clear to everybody, neither the Obama Administration nor Congressional Democrats ever had any intention to create a bipartisan product. What they wanted to create was a bipartisan mirage.
For those concerned citizens who are thirsty for a more efficient, less costly health care system, this mirage is doubly disappointing. Not only have we all wasted time on legislation that won’t fix the problem, the Congress seems to be getting ready to pass legislation that will make the problems even worse.