Thursday, September 24, 2009

Ten Reasons for Compromising on Health Reform


Prelude:
In a September 23 piece, David Brooks, a New York Times columnist, gives these reasons for compromising on the Baucus Health Bill.

First, something is going to pass; the only question is its nature.

Second, whatever passes will be based on the Baucus bill. If Obama was really a socialist, he wouldn’t be pushing the least liberal of the alternatives.

Third, the left is in an uproar over the bill. That should tell you something.
In politics you don’t get to choose your options, you only get to select from the available options.

Fourth, Republicans have all along said that the bill should not make our fiscal situation worse. The Congressional Budget Office says the Baucus bill is deficit neutral over the first 10 years and would save money over the next 10. The C.B.O. number may not take into account the various political inevitabilities. Still, that’s pretty darn impressive.

Fifth, the bill, as currently constituted, forces many Americans to pay for their health care. This is a step toward a consumer-driven system, and not the only one in the bill.

Sixth, the bill would lead to widespread coverage. Republicans let Democrats do most of the talking about this, but it is a social good, as anybody who has seen the anxiety of the uninsured knows.

Seventh, there will now be a major tussle over the shape of the bill. Liberals are going to try to pull it to the left, by increasing subsidies and reducing the revenues, making it less fiscally sound. If Republicans sit out the fight, then the liberals will surely succeed and we’ll be back where we were a few months ago, on the path to fiscal suicide.

Eighth, Obama has at least signaled a willingness to look into tort reform and other issues Republicans care about. This is an opening they should try to drive a truck through.

Ninth, the Baucus bill does have some reforms like comparative effectiveness research and bundling that really could lead to some gradual progress toward a sane health care system.

And tenth, the bill also taxes employer health benefits. This too could move us gradually to a less distorted system

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