Conservatives Need to be Part of Health Care Reform

Stuart Butler, Vice President of Domestic Policy at the conservative Heritage Foundation has an op-ed in Thursday’s Washington Times, “Four Steps Can Heal Health Care.”He makes some very valuable points and proposes four steps toward reforming the health care system most people—liberals and conservatives —could agree on:

  1. Making sure every working family has access to an affordable private health plan
    that could include state-based default plans with agreed upon minimum
    benefits and premiums subsidized through reinsurance pools that spread
    any adverse risk over the broad private market.
  2. Encouraging insurance exchanges not unlike those envisioned by Democrats but at the state level where Stuart sees these exchanges avoiding “endless Congressional micromanagement.”
  3. Reforming the existing federal tax preferences for health insurance by capping the value of these tax breaks as a means to encourage more efficient plans and raise revenue to help pay for premium subsidies
  4. Redesigning the Medicaid and SCHIP programs
    by giving states the ability to streamline these programs and free-up
    funds to expand the help the low-income people get for health
    insurance—including vouchers to purchase private coverage.

The liberals are not going to achieve health care reform on their
own. Liberals and a few moderates aren’t either. Trying to get 52 or 55
votes in the Senate will not be enough. Without broad based
Congressional support opponents of any reform bill will cut it to

In order to make the country as a whole comfortable that the reworking of the American health care system
is going to be for the better we are going to need a broad consensus
that reaches into the ranks of at least some conservatives as well. The
American people need to see more than liberals and more than Democrats
standing up for it.

Don’t forget, 85% of all Americans have health insurance.
They may be worried about it and its future, but they have it and it
isn’t hard to scare them into thinking that the risks of change still
outweigh any big unproven new programs. Harry and Louise are still
alive and well and easily spooked.

Stuart Butler’s op-ed should remind Democrats that conservatives
have a lot to contribute to this debate, and if they really want to
build a broad based coalition toward health care reform
our people can feel comfortable with, it would be wise to reward
goodwill offerings like this with a goodwill opportunity to be
genuinely part of the process.

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3 replies »

  1. Healthcare is an extremely complex money train with a lot of diverse players. This issue deserves an intelligent detail review of all the issues. The Devil is in the Details.

  2. Here are the essentials of what I want policy makers of both parties to know:
    We can provide more health care than we can afford to provide. As hard as it is, we must take the time to define what is essential care that everyone needs access to. The richest among us will always find a way to get “everything” they want, but too often we have adults and children not getting the minimum of what is needed.
    I am very concerned about the co-option of research by big money intersts not just in the pharmaceutical industry but in chronic disease management. If you can get your test, your protocol, your program to be called a best practice you can make some money on it. I’m not adverse to researchers making a profit on a lifetime of work but we need to work to define essentials of hypertension, diabetes and heart disease management, not to note every sort of optimal thing that could be done.
    My husband is a family doc, I am a nurse in a school system. He does not want to be rich but he would like to be fairly remunerated for what he does. There is nothing about Primary Care that will lure bright young people in to it as it stands. And that will be our loss in the future–the very near future.
    Policy makers need to squarely face the cost of our convuluted, multi-payer system not just to medical practices but to DME’s, pharmacies and other ancillary providers. This summer, I worked in the vaccine clinic of our local county health department. It was not uncommon to see someone who had waited an hour or more in the waiting room while some clerk navigated the (purposefully) tortuous system to find out if a vaccine was covered. This determination was necessary to figure out which source of vaccine supply I, the nurse, would use. No one would want to be treated this way. And yet this scenario plays out daily in medical office and ancillary care providers every where.
    That’s what I want them to know.

  3. None of the proposals deal with system costs, improved utilization, or affordability; they only propose payment shifting. Working within the present insurance system will not give any more citizens the needed income to pay for good coverage or the ability to pay co-pays and deductibles. If we are led to believe that insurance companies make only small amounts of profit from health insurance, then we have to assume that premiums to benefit payouts are based on realistic assessed risk to cost. Somehow drawing more insurance companies into larger risk pools and re-insurance does not do anything for the underlying problem, except put lipstick on the proverbial pig. State exchanges will only offer less insurance for less price. As homeowners were lured into bad mortgages with low initial monthly payments they will also be lured into high deductible plans with unaffordable co-pays, and again we will have the private market’s equivalent of an unfunded liability.

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