As the nation watches Congress and the administration engage in a final back and forth on health reform legislation, it is worthwhile to imagine what might still be if Democrats and Republicans chose -- for this historic moment -- to set aside political opportunism and put the interests of the country first. What if every U.S. Senator and Representative acknowledged, at least for purposes of this debate, that getting 80-85 percent of what one wants is noble enough?
While I'm pleased with my party's commitment to provide quality health coverage for millions who currently go without it, make sure that health insurance covers preexisting conditions, and crack down on unfair insurance industry practices, I'm deeply concerned -- both for the prospect of meaningful, pro-growth health reform and, frankly, my own party's ability to govern post-health care -- when I hear of a reconciliation approach. "Starting over," as many Republicans would have it, is not the right solution, but the proposal before Congress contains too few of the practical, quality-improving measures that nearly everyone supports. Quite simply, it places too much emphasis on heavy-handed policies that would likely imperil any chances of bipartisan legislation on other important issues such as education and entitlement reform.
For example, those hoping to replace dated paper forms with easy-to-share, private and secure electronic medical records -- a move almost everybody who studies health care policy agrees would improve care, increase efficiency and bring down health care costs -- will remain disappointed with the handful of modest moves the bill makes in that direction. Likewise, although the proposed legislation slightly expands efforts to pay doctors and hospitals more for high quality care and less (or even nothing) for ineffective and harmful medical procedures, America's overall health care system will continue to operate with few effective quality measures if the current Senate proposal becomes law.
Even non-controversial (and arguably urgent) efforts to help Americans manage deadly chronic conditions like diabetes, obesity, and heart disease remain an afterthought in the Senate health care bill now under discussion in the House of Representatives. It's important to note that treating patients with chronic diseases accounts for 75 percent of U.S. health care spending today.
While giving short shrift to many popular, commonsense and pro-growth ideas, the current bill also contains a little-known price control mechanism, the Independent Payments Advisory Board (IPAB), that could well serve to undermine access to quality care and increase costs for millions of America's most vulnerable citizens. At a time when seniors are increasingly frustrated with the political discourse in Washington, it's critical that policymakers recognize the consequences of making changes to Medicare. And since it's America's largest payer of medical bills and a de facto benchmark for many private plans, anything the Board suggests is likely to have a ripple effect throughout the entire health care system.
One program that has received overwhelming praise from the seniors who use it (90 percent in one recent poll) is the Medicare Part D drug benefit. Placing new burdens on the program would be a political and practical mistake since average premiums remain modest and costs to taxpayers sit at levels significantly below initial predictions. The nonpartisan Congressional Budget Office, however, projects that drug premiums could go up by as much as 20 percent if something like the current health reform bill becomes law. Seniors, understandably, will be even more upset and confused if this happens (especially those in Medicare-rich states like Florida, New York and California).
Throughout history, in the name of national need, members of Congress have set aside politics, reached across party lines and worked together. Even on issues in which there is a tremendous diversity of opinion and wealth of emotion, history tells us it is possible for both sides to join together and pass good policy. Most of the important legislation ever passed in this country has been both bipartisan and embraced by the majority of the electorate.
This needs to be one of those times.