With a report out from the Centers for Disease Control and Prevention revealing that one in five Americans cant get the healthcare they need, a major physicians group seriously entertaining the idea of a single-payer system and presidential candidates duking it out daily over the issue, healthcare reform loomed ever larger last week. However, as this page has noted, the odds of any of the current reform plans being enacted as written are about the same as a lottery windfall. So this might be the time to discuss what real, bipartisan reform might look like.
The fact is that even if a reform-minded Democrat wins the White House (as is likely) and the Democrats keep control of both houses of Congress next year (even more likely), any reform plan will likely need at least some Republican support. Many on the right see any form of expansion of government-paid care as unacceptable, and would use the Senates arcane rules to block a plan that includes it. It is hard to see the Democrats gaining the needed 10 votes in the Senate to prevent filibusters.
As it turns out, there is already legislation on Capitol Hill that might serve as a template for bipartisan reform. It was offered in January by Sen. Ron Wyden (D-Ore.), who long has championed universal coverage but now wants to actually do something about it with colleagues on the other side of the aisle.
Wyden and chief co-sponsor Bob Bennett, a conservative Utah Republican, have garnered key GOP support for the Healthy Americans Act by promising to end most employer-sponsored care while holding the line on healthcare spendingperhaps even reducing it. Other key Senate backers of the plan include Mike Crapo (R-Idaho), and Chuck Grassley (R-Iowa). Not exactly a radical bunch.
As Crapo puts it: The Healthy Americans Act is an important first step towards comprehensive bipartisan healthcare reform in the United States which aims to provide every American with health insurance while simultaneously recognizing the importance of a free-market approach.
It is in many ways a radical plan. Employers would be able to drop healthcare coverage, but initially would have to pay workers the amount of money they used to contribute to premiums so workers could afford private insurance, which they would be obligated to purchase. The private market would be dramatically re-engineered to offer a menu of coverage equal to what members of Congress have available.
Insurers would be proscribed from denying coverage or making it more costly based on peoples health status or age. Subsidies and tax credits would allow people making up to 400% of the federal poverty level to get assistance paying premiums. And new state Health Help Agencies would drive down insurance costs by steering people to the lower-cost plans and coordinating payments from employers, individuals and the government.
There would be strong incentives for individuals, providers and insurers to focus on prevention, wellness and disease management.
This plan, those using different nomenclature, has a major tax increase in it because employers would be helping to offset the costs of subsidized coverage. But Republicans could crow about taking away the burden of healthcare coverage for those businesses that no longer can afford it or are losing the competitive race with foreign companies that benefit from not having to offer it.
One can quibble with any aspect of the plan, as with any reform initiative. But the point is that without including some of the free market ideas of those Republicans who support universal coverage, Democrats wont succeed in passing legislation and the nations 47 million uninsured will stay that way.