Winning Republicans Over on Health Care Reform

The Obama presidency began with inspirational talk about transformational leadership and solving the country's most challenging problems through a bipartisanship approach that would eliminate Washington bickering. Health care reform, a cap-and-trade energy bill, financial regulation and an economic stimulus bill were among the centerpieces of the domestic agenda.

What happened to health care reform?

Today's Democratic dilemma with health care reform transcends partisanship: we really need to constrain health care spending lest we bankrupt the country. Expanding coverage without curbing costs and changing the incentive structure of our inflationary, fee-for-service model is a recipe for fiscal irresponsibility that we cannot afford. The Massachusetts senatorial election makes it evident that the electorate has come to this conclusion. The Democrats need a way out of this mess; so does the country.

When President Obama arrived at the White House, a bipartisan approach to health care already existed. Liberal Oregon Democrat Ron Wyden and conservative Utah Republican Bob Bennett co-sponsored the Senate's "Healthy Americans Act." It was already drafted, had been scored by the Congressional Budget Office as actually reducing the deficit, and had garnered 18 co-sponsors: 8 Democrats, 9 Republicans, and one Independent. Their approach provided near universal coverage, and it also reformed the existing fee-for-service structure in ways that included economic incentives for serious cost reductions.

Wyden-Bennett also received endorsements from commentators as diverse as David Broder, David Brooks, Lanny Davis, and Matt Miller.

Instead of turning immediately to Senators Wyden and Bennett, the new President essentially delegated health care reform to House Speaker Nancy Pelosi, Senate Majority Leader Harry Reid, and Senate Finance Committee Chairman Max Baucus. The results were highly partisan bills in the House and Senate that only passed by the narrowest of margins. Wyden-Bennett wasn't even an afterthought, and some Democrats thought Wyden was just meddling.

What Congress has now produced is not change to believe in but more status quo. There have been endless turf battles, backroom deals with big pharmaceutical companies and big labor, the appearance of Senatorial votes being bought (Nelson and Landrieu), illusory and unlikely-to-be-realized cost savings, less than universal coverage, health exchanges that are too small or too constrained to be successful, and no real structural reform that would change the unsustainable economic incentives of the current system.

The House bill that passed in November by five votes is significantly different from the Senate bill passed on Christmas Eve. After Scott Brown's upset in Massachusetts, it is inconceivable that House members could now vote to accept the Senate bill unamended.

If Obama is serious about health care reform, transformational change, presidential leadership, and his own political future, his only solution now is to go back and include the bipartisan themes from the Wyden-Bennett "Healthy Americans Act." One of these themes is to offer every American a choice of competing plans, just like Members of Congress have. This is the best solution to build a viable health-care marketplace for the American workforce. Our workforce desires - and deserves - portability, transparency and choice of quality health plans at a price that is affordable and accountable. If Obama did this, I would be one Republican who would publicly support national health-care reform legislation.

Charles Kolb, who served in the first Bush White House, is president of the Committee for Economic Development, a business-led think tank. The views in this article are the author's and not those of CED.