The New York Times invited several conservative and libertarian analysts to comment on the Republican approach to health care. Here’s my contribution:
House Republicans have already offered an alternative to what the Democratic majority was pushing in 2009. They, and their counterparts in the Senate, would suffer no political consequences if they chose not to go any further than what’s already been proposed. Republicans didn’t drive the legislative process into the political ditch; the Democrats did, and voters know it.
Moreover, the public has been unnerved by what’s taken place over the last year. The administration and Congress were using every lever at their disposal to try to pass a sweeping reform program that was plainly at odds with what the public wanted. Quite understandably, they do not trust that the political process is capable of producing a sensible, consensus-driven reform program that can garner broad bipartisan support. Consequently, for the time being, they would rather see the whole subject go away and move on to other more pressing topics.
But it does seem unlikely that the Democratic majority will be able to walk away from the effort that easily. It is quite possible that Congressional leaders will reach out to Republicans to try and forge a compromise around a more targeted measure. If that call does come, Republican leaders should insist on three things.
First, states must be given the lead role in reform, not the federal government. And they should have the flexibility to implement programs without having to jump over bureaucratic hurdles put up by federal agencies. Second, state-based high-risk pools, not cumbersome insurance regulation, should be enlarged and reformed to help those with pre-existing conditions get affordable private insurance. And third, to begin to control costs, there must be meaningful medical malpractice reform nationwide.
Anything much beyond these ideas will begin to weigh down the effort, and lead to its collapse as well.
The entire mini-symposium, which includes a contribution from Keith Hennessey, is on the NYT website here.