By Robert Laszewski

Sen. Max Baucus (D-Mon) released his much-anticipated healthcare proposal Wednesday.

By ROBERT LASZEWSKI

The next big test for a health care bill in 2009 (notice that I did not call it health care reform) will come in Senate Finance. The final vote in that committee will tell us a lot about whether the Democrats have any chance for 60 votes in the full Senate. So far, it does not look good.

I have the greatest respect for Senators Baucus and Grassley and their good faith efforts to find a bipartisan health care solution. But I also think their efforts were fatally flawed from the beginning.

I think the problem is that Baucus and Grassley were trying to bridge the wide chasm between liberal and conservative ideas. Finding the fine balance necessary has created an unwieldy compromise—no one is happy. Most striking, the compromise reached between cost and premium subsidies has yielded an $880 billion bill that requires middle class people to buy health insurance they will in no way will be able to afford. On top of that, the policies have big deductibles and out-of-pocket costs.

As I have said on my blog before, we cannot do something as big as health care reform without bipartisanship. The American people will never be comfortable with one side’s proposals so long as the other side is taking shots.

Any successful health care effort will need political cover from at least some respected members of the minority party.

This health care effort has occurred on one side of the political spectrum. Grassley and Baucus tried to bridge a wide chasm between the conservative side and the liberal side and were only able to build a rickety bridge across it that, it would appear, Grassley can’t even sign onto.

To get this done, we will need to build a consensus on health care from the middle and then build out. We need to start with the things everyone can agree on and then push simultaneously as far right and left as we can go and still hold a consensus.

I know I have said this a few dozen times before on this blog, but Wyden-Bennett is an example of that middle-out model.

You might respond that Wyden-Bennett is off the table.Have you noticed the growing number of times that name keeps coming up?*

Robert Laszweski has been a fixture in Washington health policy circles for the better part of three decades. He currently serves as the president of Health Policy and Strategy Associates of Alexandria, Virginia. Before forming HPSA in 1992, Robert served as the COO, Group Markets, for the Liberty Mutual Insurance Company. You can read more of his thoughtful analysis of healthcare industry trends at The Health
Policy and Marketplace Blog, where this post first appeared.

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