Reigniting Support for Health Care Reform With a Broader Consensus

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January 20, 2010 by D Stack

To quote a blog at the Village Voice, with the election of Scott Brown in Massachusetts, the Republicans have captured a majority in the US Senate, holding 41 seats to the Democrats’ paltry 59.

It’s obviously an enormous exaggeration, as the Democrats still have a greater majority than the Republicans ever did throughout the Bush presidency. But the point being the Republicans now have the power to block legislation via a filibuster should they desire to do so. All signs are they do desire to do so. I suspect Harry Reid could call for a vote on dropping the capital gains tax and Republicans would filibuster.

How did Bush manage to get so much of his agenda passed? I believe it was by offering legislation that was impossible for the Democrats to pull off a filibuster without risking the wrath of voters. As Scott Brown’s victory over Martha Coakley shows, there is no such thing as a 100% safe seat.

So about health care reform. The health care bill was headed for negotiation between the House and the Senate. However, that assumes that the Senate will be able to even bring it to vote. Due to the rules of the Senate that is unlikely. The House can simply pass the Senate version of the Bill. That too seems unlikely, given Congressional Democrats showing their traditional bravery (“omigod we’re DOOMED DOOMED DOOMED I TELL YOU!!!!!!”)  There is “advice” from Republicans telling Democrats what lessons they should learn from this. I’d suggest that advice be ignored. I suspect Republicans don’t want to help Democrats. Just a hunch.

As it stands now, health care reform is dead. And as a result people will continue dying owing to lack of insurance. Now this may be ok if you subscribe to absolute personal responsibility, to the extent that if you get a cancer diagnosis, you either pay for it or die

I do not subscribe to this. But one thing is clear. Republicans were able to exercise fears of the big bad federal government with its sinister bureaucracy. Americans like to believe in the Reagan ideal of small government even when it runs into the problem that absolute personal responsibility is a disaster for tens of thousands of people, often due to the misfortune of their own birth or just plain bad luck.

But to be honest, there is something to say about the Republican argument. Anything that is a gazlillion pages long is loaded with pork, with gifts for special interests. It allows Republicans to stoke the fears of the people.

So that brings me back about what sort of legislation to pass. Obviously the spooky health care reform is too big. Even if the Democrats could get it through the House it is too complex to grasp what it accomplishes. Break it into pieces then. Accomplish something. Build up a record of getting things done. Start with things that are so common sense that you dare the Republicans to vote against it at their own peril, much less filibuster it.

Where to start? I’d suggest beginning with banning the practice of rescission. This is how health insurance companies drop people due to undisclosed preexisting conditions, though often with the merest figleaf of justification. You were treated for a rash, unaware it was a sign of skin cancer. Boom, you’re off insurance when skin cancer is diagnosed. Simply ban it. When I buy a used car I buy it as-is. When I bought my house it had no warranty. Say you give insurance companies one month to find fraud from an applicant from the time a policy starts.

Does this fix health care? No. But it is a start. It helps lots of people. Good luck filibustering this.

Next I’d try to tackle the health insurance of the unemployed. COBRA was designed to help people maintain their coverage while they are unemployed by purchasing it via their former employer, but the cost of it is prohibitive. What about allowing the unemployed and their families to buy into medicare while they are unemployed? The budget would certainly need to be crunched, but it would seem a reasonable addition to unemployment insurance. A bit more challenging than banning rescission, but again, something tough to filibuster. “My opponent wants the unemployed to die if they get sick while out of work.” “My opponent wants to force the laid off to choose between their homes and the health of their children.’

From there I believe you begin trying to increase the overall pool of the insured. This is almost certainly more controversial than the previous two, as it would put more regulations over insurers and quite likely citizens as well. But this is where a build-up of credibility helps greatly. Consider something like mandated insurance in Massachusetts or Hawaii, where everyone is required to have insurance, though insurers are therefore prohibited from excluding people. And in so doing a single rate could be mandated as well as the larger pool would allow for coverage of preexisting conditions at a common rate – you can’t just buy insurance when you get sick. Scott Brown supports the system in Massachusetts, so it is certainly something that would be difficult to justify filibustering.

The key in all of these is they all accomplish something. Something concrete that you can point to. You’re not justifying, you’re not explaining. I’ve heard that if you are explaining you position in politics, you have already lost the debate. You need a moral high ground. You need bills that can fit on a few pages. Now there are some problems with this – Democrats are not, shockingly, immune to lobbyists. They’ll need to be bold and show their allegiance is to the people, perhaps foregoing campaign contributions and aid in return for doing what is right.

And I think this needs to be introduced the right way. I’m looking at you Senator John Kerry of Massachusetts. As the senator who served with Ted Kennedy for many years, I believe you have the moral standing to complete the dream of your fellow senator from Massachusetts. Ted Kennedy learned how to be a pragmatist and not let the perfect block the good. I certainly believe he would support such a program. And Senator Dodd of Connecticut, who was close to Senator Kennedy and, as he is not running for reelection, is untouchable by lobbyists, would be an ideal co-sponsor in the Senate.

Doing this would help real Americans with real problems. It would replace a scary gargantuan reform package with easily understood pieces, each with a clear and desirable benefit. It would send the message from the Democrats that the message of suspicion and dissatisfaction was received. It would make the process far more open. And again – it would help real Americans with real problems.

Senator John Kerry – (202) 224-2742 – [email]

Senator Chris Dodd – (202) 224-2823 – [email]

[As an aside the thought of being DOOMED hit me pretty hard last night and this morning, so it is a natural reaction. My brother (who is way to the left of me) and I had a conversation today about what could be accomplished – as it is clear that something needs to be done – and a lot of this post reflects thoughts from that conversation as I slowly backed away from the cliff…]

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