February 21, 2010

February 21, 2010 | Commentary on Health Care Reform, Health Care

To Reform Health Starting Over is the Only Way Forward

In the wake of losing its supermajority of Democratic senators, the White House has been scrambling to figure out the "art of the possible" to salvage some measure of ObamaCare.

But recent public opinion polls from Gallup and Pew Research Center, along with exit polls from many Massachusetts voters, show that many Americans reject the notion that a brand-new bloated government entitlement program is the way to solve the nation's health-care problems. Instead, they want lawmakers to scrap their current course and start with smaller measures that have genuine bipartisan support.

It's not a far-fetched notion. Conservatives and others have been promoting solutions that don't involve Congress centralizing control over more of the private health-care sector, or spending more than a trillion dollars on new health entitlements. Those alternatives have gotten lost in the liberal rhetoric -- where anyone who refuted ObamaCare was labeled a shill for the "party of no" -- but they exist and still hold the potential to ease America's spiraling health-care costs and rising uninsured population rate.

Here are just a few broad principles that conservatives and others can rally around to achieve meaningful reform:

Create tax equity in health insurance for all Americans. Today, if workers buy health insurance through their workplace, they receive unlimited tax breaks on the value of their insurance plans. But if workers try to buy insurance on their own, they don't get any kind of tax benefit. This inequitable and regressive tax policy, which makes health care more expensive for millions of Americans, has contributed to more people being uninsured.

Congress should provide tax relief for American taxpayers who do not or cannot get their health coverage through the workplace. This would stabilize the market, enhancing the portability of coverage and sharply reducing the number of uninsured.

Allow states to experiment with health reform efforts. Each state is different when it comes to the health challenges facing its citizens. Some states face a high rate of uninsured citizens. Others are more concerned about dealing with crippling costs. Instead of a federal, one-size-fits-all approach, Congress should promote federal-state partnerships that preserve the states' diversity and promote states' innovation.

States could enact insurance-market changes that encourage health-insurance portability, whereby workers could take their same health benefits and premiums from job to job. They also could create medical-malpractice reforms that encourage doctors to locate in their states while protecting patients' rights.

Meanwhile, Americans should be free to buy insurance anywhere in country. They should be able to select from plans sponsored by associations as well as traditional insurance companies, instead of being restricted to companies in the state where they live.

Enact meaningful entitlement reform. Medicaid and Medicare's out-of-control spending is accumulating mountains of debt, while driving health-care costs higher.

Congress should immediately address the health programs under its own jurisdiction. It should include the long-term entitlement cost estimates as a factor in the annual budget process. This means that Congress would no longer punt the impending fiscal crisis down the road, pushing the rising costs off on future generations. Americans can no longer blindly pay into a system that offers little incentive for efficiency from health-care providers or consumers.

If Congress and the White House are serious about connecting with the American public and offering up solutions that enjoy broad support, they need to throw out the current legislative playbook. They also should forget ramming through unpopular health legislation in piecemeal fashion, using the budgetary tactics of reconciliation or other less-than-transparent methods that attempt to mask their federal takeover of the health-care system.

Let's start the conversation on true bipartisan health measures -- where taxpayers have a voice.

Robert E. Moffit, Ph.D. , is Director of the Center for Health Policy Studies at The Heritage Foundation.

About the Author

Robert E. Moffit, Ph.D. Senior Fellow
Center for Health Policy Studies

Related Issues: Health Care Reform, Health Care

First appeared in The Providence Journal