HEALTH REFORM: Reality Check...This Is Not Socialized Medicine!
I am disappointed to hear the health reform conversation devolve once again into a contrived debate about a single payer, government-run health system. This is an old dispute about "socialized medicine" and one that has already been settled in the minds of a critical mass of policymakers.
In my 20-plus years in the health policy business, the debate about health reform has evolved dramatically. In the 1990s, we talked about coverage far more than cost and quality. Yet today we realize that the success of health reform hinges on a credible roadmap to increasing value and controlling cost growth. In addition, Americans who followed the health reform debate throughout the 2008 presidential race witnessed history. For the first time in my lifetime, Republicans proposed supply-side incentives like payment reform, and Democrats emphasized cost control and the need to build on the current system to cover all Americans.
Let me be clear: there is no serious proposal for a single-payer, government-run health system being discussed in Congress or within impactful policy circles.
Democratic leadership believes in a patient's right to choose their insurance plan and their doctor and they recognize the value in market competition. Leaders from Senator Max Baucus to Senator Ted Kennedy to Speaker Nancy Pelosi to President Barack Obama support a private—public approach to improving our health system and ensuring that all Americans have quality, affordable health coverage.
This is simply the latest distraction from the real issues in the health reform debate. Today, the health reform debate faces a new, important challenge: should a public insurance product be allowed to compete with private health plans for the business of the under-65 population? And if so, is it possible to structure the rules so that public and private plans can compete fairly?
While these questions are legitimate, they are leading the health reform conversation to what could be a premature impasse. In the coming days, John Bertko and I will be releasing a policy brief that explains how we can achieve many of the goals of public plan advocates while preserving fair and effective market competition, negating the risk of excess cost-shift, and avoiding a potential progression toward a single-payer health system. In short, I submit there is a credible policy solution to this emerging standoff.
A couple of years ago, Republican Sen. Chuck Grassley stood on the Senate floor during the SCHIP debate and questioned the Bush White House over its decision to veto the children's health insurance program legislation he had painstakingly negotiated on a bipartisan basis. "How intellectually dishonest can you be," Sen. Grassley asked. This is a moment I think of often. I still have his speech on my wall. As we approach this important conversation in our nation's history, we owe it to ourselves and to the nation to be intellectually honest about the policy choices we have before us and reasonable about what it will take to achieve our goals. To do this, we must engage in the policy debate of today, not yesterday. Stay tuned, and do not be distracted from the real issues.