President Obama's call for a bipartisan discussion of health care ideas represents the first opportunity to have a real dialog - if both parties are willing. My advice to the Republicans would be to move away from the combative tone of the February 8 letter from John Boehner and Eric Canter and to proceed about as follows:
1. Have a leader so that President Obama doesn't preside over the meeting alone. Logically, it should be Senate leader Mitch McConnell or House leader Boehner - or both. Demand equal time with the Democrats. Face time should be given to members who can articulate a clear position - Paul Ryan, Olympia Snowe, and a few others. Newt Gingrich's suggestion of a governor or two would favorably change the dynamic.
2. Emphasize your understanding that the public wants reform that reduces cost and extends coverage to most of the currently uninsured. Disavow the current unpopular House and Senate bills as the logical starting point. If this is resisted, have available a list of the most objectionable provisions.
3. Lead with some simple principles: all states should be treated equally; individuals should not be treated differently if they belong to unions or not, and if they work for the private or public sector; we should move toward a system where the individual is in charge; rely on free markets; reward individuals for good health practices.
4. Demonstrate that Republicans have been offering recommendations for a year, but that despite Obama's promises of March, they were totally excluded from the House process and from Obama and Reid's secret negotiations with the special interests. Give some specifics on the dates that suggestions were made.
5. Provide summaries (and Congressional Budget Office financial estimates where available) for the top five or ten ideas - perhaps divided into "do it now", and "do it once we have figured out how to make it affordable":
a. Do it now (cost reduction):
- Pharma - allow government price negotiation; allow re-importation where prices for US drugs are cheaper overseas; accelerate approval of generics, particularly biotech;
- Insurers - allow purchase across state lines; eliminate insurance industry anti-trust exemptions; eliminate inclusions of specific treatments in policies; require that a standard "bare bones" policy be offered;
- Insurance purchasing - allow insurance pools for individuals and small businesses; equalize tax treatment for employer-purchased and individual-purchased policies;
- Medical facilities - reacquire adoption of information technology; prohibit doctors owning testing facilities; aggressively support "best practices"; require transparency of billing information;
- Individuals - make policies portable; require significant co-pays and deductibles in any government policies.
b. Prepare to do as costs come down (cost increases):
- Reform insurance regulations to prohibit denial for pre-existing conditions and lifetime caps. Include an independent estimate of the cost increases to be expected in insurance company premiums;
- Establish a minimum government-subsidized policy for all legal residents;
- Create a bipartisan commission to make recommendations on ways to return entitlement programs to solvency - Medicare; Medicaid; Social Security;
6. Be prepared to respond to Democratic proposals or other contentious items - mandatory purchase of insurance; illegal immigrants; government support for abortion; public option; single payer. (All losers for the Democrats.)
7. Recommend a process for going forward toward legislation.
It would seem that President Obama is out of ideas on how to get his program through Congress, and that this is something of a "Hail Mary". If it does not result in something that allows him to peel off a few Republicans in the Senate, then he can campaign in November as having sought a bipartisan approach, despite a year to the contrary.
Based on recent polls, the public wants reform, but is increasingly opposed to what the Democrats have offered. An offer to start over on legislation with the above elements would clearly identify the Republicans as the party of responsible ideas.
And speaking of "common ground", here is Joe Biden calling Iraq one of the great achievements of the Obama administration. Kind of like the TARP program, begun by George Bush and Hank Paulson. Beyond that, what is there?
And for my Air Force Academy friends, this video was shown on the Brigham Young University stadium screen shortly before the football game against Air Force. (BYU won 38-21.)
bill bowen - 2/12/10