Can There Be a Good Compromise on Health-Care Reform?
Earlier this week, Oregon's Ron Wyden and Utah's Bob Bennett co-authored an op-ed for The Washington Post arguing that the Healthy Americans Act represents a bipartisan path forward for health-care reform. But they weren't the only ones. Along for the ride were Sens. Debbie Stabenow (D-Mich.), Ted Kaufman (D-Del.), Daniel K. Inouye (D-Hawaii), Mary Landrieu (D-La.), Joseph I. Lieberman (I-Conn.), Bill Nelson (D-Fla.), Judd Gregg (R-N.H.), Michael D. Crapo (R-Idaho), Lindsey O. Graham (R-S.C.) and Lamar Alexander (R-Tenn.).
If you're keeping count, that's five Republicans and seven Democrats. Notably absent were Maria Cantwell, Jeff Merkley and Arlen Specter. All three are co-sponsors of the bill, but none want to step in front of Max Baucus's process right now or be seen advocating an alternative to the process that the White House has developed. Still, that's 12 senators on one op-ed arguing for one thing. It's a pretty impressive achievement.
The Wyden-Bennett process is what bipartisanship should look like but doesn't. Too often, bipartisanship takes the form of the final days of the stimulus bill, or the current co-op compromise: Rather than combining the differing insights of both sides to make a bill better, it simply makes a bill smaller, and less likely to achieve its desired impact. That isn't the union of differing approaches. It's the purchase of a few cross-aisle votes.
The Healthy Americans Act is the other type of bipartisanship. The presence of Republicans and Democrats has made for a more, rather than less, ambitious bill. The liberals want to end employer-controlled health care. They want radical integration of the health-care system. Totally universal coverage. Broad subsidies. Conservatives have brought an emphasis on developing a working market. An understanding that people should understand the full cost of their health-care insurance. Both sides have been serious about cost control. It has some real problems in how it structures its subsidies, but it is, in the aggregate, much better than anything we are likely to get. It's like single-payer delivered by the market.
The Healthy Americans Act, however, is not viable at this point. It's much more radical than anything on the table. It's loathed by unions and rejected by most conservatives. It would change the insurance that almost everybody has, whether they like it or not. It's very good policy. But you have to pass legislation through the Senate you have, not the Senate you want.
And in the Senate we have, the Healthy Americans Act was never actually embraced by a solid bloc of senators. The co-sponsors praised the process but didn't commit to voting for the bill. The Republicans did not throw real support behind the framework. Chuck Grassley signed on as a co-sponsor and then dropped off when the real action began. It never had sufficient support to become a real vehicle for health-care reform. The bill is bipartisan enough to be interesting, but not bipartisan enough to pass.
In the end, the arc of the Healthy Americans Act shows two things. The first is that we could have a better Senate than we do, a Senate in which members of both parties try to unite their insights into good and ambitious policy. The second is that even if the beginnings of that Senate can be glimpsed in this or that process, it is not yet the Senate that emerges when there is actual legislation to be passed. If things were different, Wyden-Bennett would be a good alternative. But the argument that needs to be made is not that Wyden-Bennett is a good alternative. It's that things are different.
As of yet, there's not much evidence of that. I'm still of the opinion that the bill's co-sponsors would do better getting behind Wyden's Free Choice amendment, which could add some of the Healthy American Act's best features to the other health-care reform bills. That would be a compromise from the ambition of the Healthy American's Act, of course. But this is a group that believes in the value of good compromises.
August 7, 2009; 10:54 AM ET
Categories: Health Reform
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