Politics & Government

Bipartisan health care effort may be easier said than done

Under either candidate, healthcare will change.
Under either candidate, healthcare will change. Jim Gensheimer / San Jose Mercury News

WASHINGTON — Even the most hardened partisans agree: Republicans and Democrats must find common ground on overhauling America's health care system or the effort is likely to fail.

After all, "we're talking about people's health here," said Rep. Charles Boustany Jr., R-La., a heart surgeon prominent in the health care debate.

"I don't think there's an ounce of disagreement about the principles. That's unique," said Sen. Christopher Dodd, D-Conn.

However, there's one huge obstacle: Republicans think that the solutions must be found in a more competitive private marketplace, and Democrats prefer that the government assures that consumers can get coverage.

Finding common ground is going to be rough.

A group of Washington elder statesmen launched a major effort Wednesday to push both sides toward the middle. Former Senate leaders Bob Dole, R-Kan., Howard Baker, R-Tenn., and Tom Daschle, D-S.D., unveiled a plan that would require individuals and large employers to buy health insurance, create public insurance pools operated by states and tax some employer-provided health insurance premiums.

At the White House, spokesman Robert Gibbs praised the former leaders' proposal. "With this report," he said, "they have demonstrated what can be achieved with bipartisan effort."

Bipartisanship has hardly flourished in Washington in recent years. In February, only three Senate Republicans voted for the $787 billion economic stimulus plan. Conflicting partisan signals on health care flared from Capitol Hill on Wednesday. Republican and Democratic leaders laid out very different health care plans reflecting very different philosophies.

Republican leaders in the House of Representatives introduced their plan by saying that "Americans who like their health care coverage (can) keep it," and any plan must "ensure that medical decisions are made by patients and their doctors, not government bureaucrats."

They'd provide tax breaks for people who buy insurance on their own, and "substantial financial assistance" to low and moderate income Americans. Small businesses would be able to band together, with the help of states, other business or trade associations to offer coverage.

All that would be aimed at making the marketplace more competitive, thus driving down costs for consumers.

Currently, said Rep. Roy Blunt, R-Mo., most people get coverage through their employers, and "the employer is only talking to a couple of people." But if coverage is more widespread, he argued, insurers would lower costs to stay competitive, and individuals and companies would find premium prices more stable.

In the Senate, the Health, Education, Labor and Pensions Committee was starting to write its own legislation, and because it has a 13 to 10 Democratic majority, senators worked from a Democratic blueprint.

The Senate plan would cost taxpayers about $1 trillion over 10 years, according to the nonpartisan Congressional Budget Office, and Sen. John McCain, R-Ariz., immediately protested.

"How can we possibly, reasonably address this bill without accounting how to pay for it?" he asked. Dodd, leading the committee in the absence of its chairman, Sen. Edward Kennedy, D-Mass., who's battling brain cancer, assured McCain that the funding will be provided.

That will largely be up to the Senate Finance Committee. That panel had been expected to write its legislation next week, but has postponed any action until next month.

The health committee's bill would make people earning about $110,000 for a family of four, currently a little less than five times the poverty level, eligible for government help with insurance premiums. That figure is expected to drop to three times the poverty level, or about $66,000, when the Finance Committee writes its version of the bill.

The Democratic bill triggered a new wave of Republican outrage. "Once again, it's rush and spend, and rush and spend — and a tidal wave of debt," said Senate Republican leader Mitch McConnell of Kentucky in a floor speech.

"Everyone in America knows that health care reform is needed in this country. But they want us to do it right — they don't want a blind rush to spend trillions of dollars in the hope the administration gets it right," McConnell said.

Majority Leader Harry Reid, D-Nev., fired back: "In fact,'' he said, "No is all we hear from Republicans these days. Instead of debating facts, Republicans have committed themselves to a strategy of misinformation and misrepresentation."

The mood was different at the Senate Health committee, however.

Sen. Richard Burr, R-N.C., laid out his views and gently warned, "we're talking about generational change for America. You're talking about a mistake that's not fixed quickly."

Dodd agreed. "I suspect we have some common interests here," he said

The former Senate leaders will try to give today's lawmakers a push by reminding them that the effort goes back to Harry Truman's presidency 60 years ago and that its prospects seem brighter today than ever. And last, that if it isn't done this year, electoral politics may block chances of passage for years to come.

"If we don't do it this year, next year's (a congressional) election year, the next year is the year before the presidential election, and then the next year is the presidential election," Dole said.

"So you're looking at five years, that's the way I calculate it, it may be off a year or two. So let's do it now. We're probably not going to get everything. It's an enormous package."


Congressional Budget Office analysis of Democratic health care bill

House Republican health care plan

Senate Health Committee Democrats' plan


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