The ACP Advocate Blog
by Bob Doherty
Tuesday, February 9, 2010
Washington, D.C. (noun): a place where nothing can move, advance or happen
Tom Toles' editorial cartoon in todays Washington Post says it all.
Washington has become a place where nothing can move, advance or happen. Having been paralyzed by a huge snowstorm over the weekend, the federal government has been closed since Monday, our roads are clogged with unplowed snow, our Metrorail system won't run above-ground trains, the schools are closed (until June, it seems)--and to top it off, another 10-20 inches of snowfall is expected in the next 24 hours. (Yes, our trains really don't run when we get more than a few inches of snow. You Chicagoans can stop laughing now.)
Of course, the snow and ice will eventually melt, and Washington will get back to normal. Not so the partisan gridlock that apparently will prevent anything from getting done even when the government reopens for business.
In an effort to break the health care reform stalemate, President Obama invited Republicans to participate in a televised, bipartisan summit, scheduled for February 25. But the House GOP leadership has threatened to boycott the event, writes the Washington Post's Chris Cillizza, unless Obama meets their many demands--including pulling the plug on the current bills and starting over. The Washington Post's Shalaigh Murphy reports that President Obama today told House GOP minority leader John Boehner (R-OH) today that that his core goals -- lowering health-care costs for businesses and individuals and expanding coverage to the uninsured -- remained non-negotiable. But Obama said he would consider GOP alternatives that accomplish the same results. He also said he would sign what he considered to be a "less-than-perfect bill."
Here's the rub. The White House and most Democrats believe a fundamental purpose of health reform must be to provide affordable coverage to all Americans--including the more than 30 million legal U.S. residents who have no health insurance. It is this core belief that caused the House and Senate to produce complex--and costly legislation--designed to ensure that 94-96% of all legal residents would have access to affordable health insurance. By contrast, Laura Meckler writes in the Wall Street Journal that House Republicans reject Obama's standard that the final bill must cover large numbers of uninsured people, quoting Rep. Dave Camp (R., Mich.) as saying: "We didn't portray our bill as being universal coverage . . . We never attempted to do that."
Instead, the House GOP alternative would lower premiums in the small and individual insurance market, with a negligible impact on reducing the numbers of uninsured Americans. According to the Congressional Budget Office, it would "reduce the number of nonelderly people without health insurance by about 3 million in 2019 and leaving about 52 million nonelderly residents uninsured. The share of legal nonelderly residents with insurance coverage in 2019--83 percent--would be roughly in line with the current share." The GOP alternative "would reduce average private health insurance premiums per enrollee in the United States, relative to what they would be under current law-by 7 percent to 10 percent in the small group market, by 5 percent to 8 percent for individually purchased insurance, and by zero to 3 percent in the large group market."
Meanwhile, most voters "want the two sides to keep working to pass comprehensive health-care reform" according to the Washington Post's latest poll. "Nearly two-thirds of Americans say they want Congress to keep working to pass comprehensive health-care reform. Democrats overwhelmingly support continued action on this front, as do 56 percent of independents and 42 percent of Republicans."
The voters may want both parties to work together, but that Democrats and Republicans can't even agree on the ground rules to meet to discuss if they can reach an agreement doesn't bode well for bipartisan progress. Digging Washington out of two blizzards may turn out to be a lot easier than advancing the political prospects for health reform.
Today's questions: Do you believe that covering the uninsured should, or should not, be a principal purpose of health reform? What issues, if any, do you think would be ripe for bipartisan support?
About the Author
Bob Doherty is Senior Vice President, American College of Physicians Government Affairs and Public Policy; Author of the ACP Advocate Blog
Email Bob Doherty: TheACPAdvocateblog@acponline.org.Follow @BobDohertyACP
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