Newt Gingrich has to be one of the most interesting figures in recent political history. His soul lives at the intersection of public policy, politics and history. Because he has been on so many sides of history and policy, political insiders greet his entry into the presidential primary campaign as “Harold Stassen-ish.” I am among them, having entered the Senate the same time Newt entered the House 30-plus years ago. I don’t know Republican House Budget Committee chair Paul Ryan, but I admire his leadership talent and regret his decision not to run for the Senate from Wisconsin. It would raise the level of health policy discourse substantially in that “august body.”
Barack Obama is undoubtedly making presidential history. Given the many policy challenges he has had to take on since January 20, 2009, plus the one he chose to take on – health policy reform, aka PPACA, there’s no question he is in a unique place in history today. But, it is the Republicans – the “Party of No” on Obamacare – that are carrying the day on bringing health policy in line with health reform on the ground in the U.S. today. Obama’s PPACA sets historic national policy goals. Ryan and Gingrich articulate the policy means to the ends of the new law.
Public health insurance programs like Medicare and Medicaid should begin now to reward success in meeting access, quality, and value goals where they exist in communities and systems across the country. On their way to converting to private insurance and “premium support” subsidies when, and only if, genuine competition comes to the insurance marketplace. Along with the information consumers of insurance and healthcare need to make value judgments to purchase.
Obama could encourage this now because he has the new law on his side. He has a budget/debt ceiling impasse which could make it possible. Unfortunately, he doesn’t know it; and it appears those in his administration charged with implementing PPACA, haven’t figured out how to do it. Bogging down in waivers and new rules and regulations which set the new law up for “socialistic” ridicule, and the president for a messy political campaign which will not, as Gingrich suggests, “lead to a national discourse” on the future of health care policy and politics.
Senator David Durenberger represented the state of Minnesota in the U.S. Senate from 1978 to 1995. Senator Durenberger is currently a Senior Health Policy Fellow at the University of St. Thomas in Minneapolis, Minn., and chairs the National Institute of Health Policy (NIHP).