Donatelli Healthcare Op-Ed Featured in Politico

February 15, 2010

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Health care summit: The Brown effect

The biggest dividend of Scott Brown’s Massachusetts Senate victory is the recent invitation by President Barack Obama to Republicans to participate in a health care “summit.”


One would have thought this would have been done last year when the president decided to make health care his main priority, but no matter. As my former boss, President Ronald Reagan, used to say, “If you can’t make them see the light, perhaps you can make them feel the heat.” Smart Democrats know that “Obamacare” is massively unpopular and that the party would be wise to work with Republicans to have something to show on its signature issue.


So the question arises, what should Republicans propose at this summit and hopefully in legislation that will be developed by the House and the Senate?


Republicans objected most to the assumption inherent in all the Democratic plans that the chief priority for any health reform bill must involve federal subsidies for the willing and mandates for the unwilling to achieve “universal coverage.” This has been an ideological objective of national Democrats since the days of President Harry S. Truman.


Republicans argued that such an approach was hugely expensive, involved the federal government more in health care decisions and threatened the benefits of the vast majority of Americans satisfied with their coverage.


As a result, Republicans would focus not on mandated universal coverage but, rather, on the cost of insurance to individuals. GOP proposals would satisfy the 85 percent of Americans who are happy with their insurance but also offer new options to individuals who want to purchase more affordable products. There are a number of good ideas that can accomplish these objectives.


Republicans believe in competition, and it is true that the current state-based insurance regulatory framework does not allow for maximum competition in many states, especially smaller states. A bipartisan reform bill would consider ways to increase the number of competing health plans in individual states through limited federal regulation, if necessary.


Republicans should also seek to stimulate, not hamper, the private insurance market for individuals. Republicans should embrace the excellent suggestion of Arizona Sen. John McCain for a tax credit to help individuals and families buy their own policies. This equalizes the tax treatment for private individuals with that of employees and families who get insurance through their employers.


Republicans must also address the problems of individuals with pre-existing conditions unable to afford insurance. House Republicans have suggested setting up high-risk pools subsidized by the federal government for such individuals. This is an approach that is far superior to “Obamacare,” which would essentially turn insurance companies into regulated federal utilities and force unwilling individuals to purchase health care plans.


Republicans believe in federalism and should seek more flexibility for states to design more effective Medicaid programs. There are numerous examples of Republican and Democratic governors doing more with less through creative uses of Medicaid resources.


Finally, Republicans and Democrats can certainly agree on reform of the medical malpractice liability system to eliminate junk lawsuits against medical providers and legislate sensible limits for malpractice awards. Again, the feds can learn a lesson from several states with Democratic and Republican governors who have already moved reform bills in this area.


These measures would not spend a trillion dollars or require massive Medicare cuts or new federal bureaucracies. Instead, they would be common-sense reforms designed to moderate the cost of health care, preserve quality and provide more options for individuals. Republicans and Democrats could both take credit for doing the people’s business.


Scott Brown is already having an impact.


Frank Donatelli is chairman of GOPAC, a training center for Republican activists and candidates.