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Commentary: GOP must offer more than ideology on health care

February 8, 2010 —

Opponents of health reform have had some success at spreading the dual myths that the plans being considered by Congress are too radical and that more effective, conservative solutions have been ignored. 

Indeed, that was the message U.S. Rep. Tom Price (R.-Ga.) delivered to President Obama during his question-and-answer session with House Republicans a few days after the State of the Union. 

To get health reform moving again, the critics say, the President and Congress must be willing to consider that the “better solution” plans outlined by conservative Republicans have equal standing as those of liberal Democrats. 

But framing the debate now as a challenge to seek ideological balance re-writes the decades-old history on this issue and belies what has happened since President Obama asked Congress to begin the reform effort a year ago. 

Virtually every point made by Rep. Price and his “Putting Patients First” alternative bill (H.R. 3400) – as  well as Newt Gingrich and other Republicans who now complain about being shut out – has been debated, analyzed and measured for costs and savings. Many of the ideas are worthy proposals (and some of them have been incorporated in the measures being considered). But they are incremental in approach and would not produce the two goals everyone seeks – providing affordable coverage to most of the 45 million Americans  now going without it, and helping control the premiums and out-of-pocket expenses for those who do have coverage.

The non-partisan Congressional Budget Office examined the Republican plan and found that it would extend coverage to about 3 million more Americans by 2019. The problem is that in the absence of other meaningful changes in the system – the kind the GOP insists are not necessary – there would still be 52 million Americans without insurance in 2019. Price’s plan would indeed cost taxpayers less, but it can hardly be described as a “better solution” to what is now on the table. 

Moreover, many of these same worthy ideas have been around for years without generating much enthusiasm by conservative Republicans when the party was in power in both the White House and Congress. Still others – like Gingrich’s call for using comparative effectiveness research to help doctors and patients make better decisions about treatments and their costs – were bastardized by opponents over the summer as “rationing” at best and a step toward “death panels” at worst. Conservative Republicans didn’t help their case for bipartisanship by not admonishing some of their favorite voices for making such outrageous claims during a critical time in the legislative process. 

There was an audible snicker in the House GOP caucus when Obama declared he was not an ideologue on the issue. But history is on his side. In the decades we have been debating health-care reform the ideologues have staked out two, largely unchanged positions on how to improve the nation’s health insurance and health-care delivery system.  

On the right, as witnessed in this debate, is much of the House and Senate GOP leadership – promoting at every turn a reduction in the role of government and a reliance on the private market and individual responsibility. On the left is a handful of liberal Democrats who believe a government-run insurance system is the only way to get all Americans covered and control costs. Those Democrats, like their GOP counterparts on the other end of the spectrum, also had a chance to make their case. Both groups were heard. Neither was ignored.   

Obama’s position and the plans now being considered by Congress represent the middle ground of this ongoing debate. They do not turn the problem over to the marketplace to solve, nor do they represent a government takeover of health care. 

Handing the president a “better solution” playbook that doesn’t stray from rigid ideology does not get us closer to our goal of ensuring that all Americans can afford quality health-care coverage. Republicans must be willing to offer a more comprehensive approach, closer to the political center, to accomplish that.