Bobby Jindal Embraces the Democratic Plan for Health-Care Reform
Bobby Jindal is no stranger to health-care policy -- quite the opposite, in fact. Before resigning from his position as an assistant secretary of Health and Human Services under George W. Bush, virtually his entire governmental experience was in health-care policy. He'd led Louisiana's Department of Health and Hospitals, and gone from that to executive director of the National Bipartisan Commission on the Future of Medicare. The guy is a bona fide health wonk. Which makes it all the more striking that his 10 ideas for health-care reform are so strikingly banal.
The argument of Jindal's op-ed is that "Republicans can lead" on health-care reform, but first they need to offer up some actual ideas. To help them along, Jindal proposes 10 of them: "Voluntary purchasing pools," which are a weak form of health insurance exchanges. Portability, lawsuit reform, coverage of preexisting conditions, transparency and payment reform, electronic medical records, tax-free health savings accounts, reward healthy lifestyle choices, cover young adults and offer refundable tax credits to the poor.
Nine of these 10 are in the current process in some form or another. Portability is achieved through the prospect of national insurance plans and multi-state compacts. Coverage of preexisting conditions is a given. Obama is funding an array of lawsuit reform test projects. Transparency and payment reform are in all the bills, as are electronic medical records, rewards for healthy choices, policies that help cover young adults, and tax credits to help with insurance costs. The exchanges make the voluntary purchasing pools look silly and small. It's a bit hard to "lead" on health-care reform when your brand-new proposals are about to be passed by the other party.
Jindal's ideas are the lowest common denominator of health-care policy thinking: electronic medical records and transparency and tax credits and purchasing pools. They eschew traditionally Republican proposals that are more radical, and thus less popular. John McCain's proposal to replace the employer tax deduction with a tax credit represented a much more serious conservative approach to health-care reform -- an approach that, for better or worse, created a system based around individuals, rather than government subsidies to employers. But he lost on it, and so ambitious Republicans such as Jindal have abandoned the underlying thinking.
The problem, however, is that they haven't replaced it with anything, so they're left mimicking the least controversial elements of the Democratic agenda. At the beginning of his op-ed, Jindal laments that "a majority of so-called Republican strategists believe that health care is a Democratic issue." But the rest of his op-ed simply proves that they're right. If Jindal, who knows this stuff cold, isn't going to be the Republican who leads on developing a new conservative consensus, who will be?
Photo credit: By Bill O'Leary -- The Washington Post
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