HEALTH POLITICS: Bipartisan Leaders Propose Vision for Reform
I applaud the bipartisan recommendations for health care reform released today by former majority leaders Howard Baker, Tom Daschle, and Bob Dole. The vision in Crossing Our Lines: Working Together to Reform the U.S. Health System is comprehensive and the policy recommendations teach us how each side can realize its core values in the policy solution. I was impressed by a few takeaways in particular:
Our status quo is both unsustainable and unacceptable. To achieve our goals, both parties must approach health reform with a shared understanding that the status quo is not an option. The first step to bipartisanship is an agreement on the underlying crisis.
Coverage and cost containment are "inextricably intertwined." As the legislative process on Capitol Hill begins, it is important that we remember coverage, quality, and cost initiatives are linked. We can't simply scale back on one part of reform without damaging our ability to achieve our other equally important goals.
Health reform should not be addressed through the budget reconciliation process nor should it be subject to a filibuster on the Senate floor. Health reform should be accomplished on a bipartisan basis to make it economically and politically sustainable over time. In addition, health care is personal and complex. The American people are more likely to trust legislation that is considered under standard procedure and supported by leaders from both parties.
Both federal and state governments have a role to play. Health reform should establish federal rules, but it should also allow states to have some flexibility in meeting those goals. The leaders outline one approach to insurance market reform that allows states to take the lead, while ensuring coverage goals are achieved.
Health reform should be financed sustainably, both through delivery system savings and additional "coverage-related" reforms. In addition to proposing delivery system incentives designed to refocus care over the long-term, the Leaders commit to scoreable savings within the delivery system. They also propose using our existing subsidy for employer-provided health care more efficiently, something that will likely be necessary to finance comprehensive reform.
On the whole, this document reflects what wisdom and leadership can contribute to our current debate. I hope current members of Congress in both parties are listening.
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