Sunday, January 24, 2010

Republicans and Health Care

Republicans have showed great party discipline in opposing health care reform. With a 41st vote in the Senate provided by Senator Elect Brown, the Democrats cannot pass health care over a Republican filibuster if this discipline holds. The leadership and many senators will oppose any health care bill as they see health care defeat as a way to hurt President Obama and help Republicans regain power. However, there may be principled Republican senators who will vote to reform health care if they believe it is good for the country.

There are a couple of major items that conservatives want in health care that I, as a card-carrying liberal, am very comfortable with. They are: tort reform to limit pain-and-suffering settlements against doctors and selling medical insurance across state lines. I don't believe these will lead to the cost benefits conservatives expect, but so what? I might be wrong and, properly implemented, neither will have a negative impact. Including them, and cleaning up some of the junk in the current bill, might be enough to get a few Republican senatorial votes.

Both California and Texas have limits on legal settlements today. It doesn't seem to save any money, but it doesn't seem to do much damage either. Limiting settlements against big companies is a bad idea, they will tend to favor profit over safety, but limiting settlements against individual doctors and other health care providers is not dangerous on any large scale as the vast majority of doctors and other health care workers care deeply about the health and welfare of their patients.

Allowing companies to sell medical insurance across state lines is no problem at all as long as the regulatory regime is taken from the state the patient lives in. The problem with inter-state insurance is that companies may move to the state with the cheapest regime, but if the rules in the patient's state apply this is is a non-issue. The additional competition will probably drive down prices, but in any case will not hurt anything. Why not include it?

If major conservative ideas are incorporated into the health care bill, it is at least possible that some Republicans will come on board. Of course, if all the Republicans are only concerned with hurting President Obama as much as possible, a real possibility, there is no hope. However, I think there are at least some Republican senators for whom country is more important than party and recognize that the present US health care system is an expensive mess in desperate need of intelligent reform.

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