Health care has become the centerpiece of many pre-election discussions among politicians. Karl Rove’s recent opinion piece in the Wall Street Journal highlights some of the strengths of the Republicans’ key proposals for health care reform, but no single political team has the complete solution.
Health care reform must bridge what Rove describes as the “deep differences between liberals and conservatives.” It is precisely this type of compromise that has led to a deluge of state-level plans. We should, on a national level, learn from these early-adopters; we cannot afford to continue the no-win game of “liberals” versus “conservatives.”
Despite that disconnect, Rove makes several key points. The tax playing field must be leveled, and health care must be portable. Regardless of one’s employment, every American should benefit from the same tax breaks and from assured continuity in coverage. At the same time, we must assure that there is another mechanism for making the cost of care affordable for those Americans whose income is too low for the tax breaks to be effective. If it becomes easier for Americans to keep a plan for a decade instead of a year, those plans are also more likely to increase their investment in and emphasis upon preventive care. Similarly, if small businesses can pool together to improve their risk stratification, the price of coverage should drop even further.
With the highly variable cost and quality throughout the U.S., it is essential to arm both patients and health care providers – doctors, social workers, physician’s assistants, and others – with accurate, meaningful data on cost and quality. Providers need to make informed decisions that take cost into measured account, without sacrificing quality or sound medical judgment. Patients need this information to make value-based decisions about where and when to access care. As a team, patients and providers can make informed purchasing decisions and improve the overall value of health care in the U.S.
The revolution that we need in health care in this country will not be defined by a single political ideology, nor need it disproportionately favor one stakeholder over another. The key to health reform will be to pool the best ideas from across the spectrum, including market-based, medically sound, politically viable, and patient-friendly reforms. As we build a higher-value, universal system, we have the opportunity to take suggestions from all key stakeholders, and the best policies will come from complex, and painful, compromise.
Marie-Adele Sorel | Health Care Program Associate
I agree that we need to find a common ground for compromise between liberals and conservatives on health care reform. But to do that, we have to agree on principles. So far, only the Democratic candidates are talking about the need for universal health care, while the Republicans are talking about liberating market forces to bring down health costs and allow more people to buy insurance. The first step is for both sides to talk about whether health care is a right, and if so, whether we need to give everyone access to good, comprehensive health care. Then we can begin to address the issues involved in doing that.
Neither side is addressing the fact that we can’t provide universal coverage until we figure out how to control costs. And neither the Democrats nor the Republicans will admit that there’s no way to do that until we restructure how health care is delivered and how providers are incentivized. The Democrats want to expand government programs and require both individuals and employers to contribute to health care–all necessary but not sufficient. The Republicans talk about changing the tax system, demanding “personal responsibility” for lifestyle choices, and bringing down costs by arming employers and consumers with the data they need to do “value-based” purchasing. Meanwhile, we’re spending twice as much per capita on health care as any other country, with arguably poorer results, and we don’t want to do anything to disturb the apple cart of hospitals, physicians, insurance companies, and drug companies. Let’s agree on principles and deal with the real problems.