Health Care Summit Post-Mortem
By Arnold Kling
I thought that President Obama did well to convey a willingness to negotiate. If I were the Republicans, I would move off the “scrap the bill” talking point and instead go with something like this.
We have some areas where we agree, some areas where we might negotiate, and some areas where we can never agree. That suggests a three track approach.
1. Fast track. For issues such as ending waste, fraud, and abuse in Medicare, we should aim to pass a bill within thirty days that contains all of the ideas on which we agree.
2. Negotiation track. These would be issues where compromise is possible. For insurance competition, the President expressed concern that allowing interstate sales of insurance could cause a “race to the bottom.” That may be a legitimate concern, but it is hypothetical. Instead of pre-emptively regulating the insurance industry, why not try the Republican approach and see what happens? Meanwhile, create an insurance industry competitive practices board that would monitor the industry and issue public reports on abusive practices. Congress could later vote to convert this board into a regulatory board if public pressure demands it.
I would put the Medicare cost commission on the negotiation track. But I have long been more willing than most Republicans to endorse doing cost-benefit research on medical procedures,
In principle, the issue of expanding insurance coverage can be put on the negotiation track. But if I were Republicans, I would take a hard line against funding expanded coverage with Budget gimmicks, enforced cross-subsidies, or Medicare cuts (again, not that I am against Medicare cuts, but they need to be applied to improving the financial health of Medicare). I would take a relatively softer line against funding more coverage with taxes in an above-board way.
3. Gridlock track. Issues like public funding of abortion or malpractice reform probably go here. Agreement and compromise are not likely.