Four different takes on Thursday’s bipartisan health care reform summit from experts at The Heritage Foundation:
Bob Moffit, Director, Center for Health Policy Studies
The President’s Health Care Summit was an exercise in public education; it was enlightening. Particularly noteworthy was the threat of rising deficits to the nation’s future articulated by Representative Paul Ryan (R-WI).
Congressional Democrats and Republicans often used similar language in describing their broad objectives: lowering the cost of care, improving the treatment of patients, and expanding coverage to more Americans. Representatives on both sides also made it clear that they have sharply different methods of achieving these objectives. The polarization at Blair House reflected the polarization in the nation at large. But the Congressional Republicans can take solace in knowing that on the specific issue of the House and Senate health bills that they alone stand with the vast majority of their fellow Americans in opposition to these measures.
While the President and Congressional Democrats would place more control over Americans’ health care in the hands of government officials, Congressional Republicans made it clear that they are seeking to sharply expand patients’ control over their own health care, not only in decision-making but in control of the flow of dollars in the system. Moreover, the summit showcased the President’s insistence that on advancing the same prescription for federal control enacted in the House and Senate by the Congressional leadership. The President’s own proposal, for example, builds off of the Senate bill. Thus, a number of features that many, if not most, of Americans find objectionable would be retained, including mandates on individuals and employers to buy insurance, and heavy federal control of private benefits and premiums. Congressional Democrats kept insisting on the need to impose an individual mandate on Americans to buy a government approved level of health benefits. It was also instructive that the President made some key factual errors in his exchanges with Congressional Republicans, such as the extent of the range of benefit mandates; in certain cases, he recognized these errors and corrected himself; an example was on the extent of the increase in health insurance premiums embodied in the Senate bill.
Since the inception of the debate, it should be noted that the President insisted that his health policy agenda did not constitute a federal takeover of the health care system. In fact, it is very much a federal takeover of American health care. In the outline of his own proposal, released on Monday, the President would add to the federal powers embodied in the Senate bill. The most important would be a new Federal Health Insurance Rate Authority, which would provide federal “assistance and oversight” to the states conducting reviews of “unreasonable rate increases” and “unfair practices” of health insurance plans. This, of course, establishes for the first time a legislative basis for the imposition of price controls on health insurance. If government can control both health benefits and health care pricing, that’s the proverbial ball game. Private health care would be “private” in name only.
Ed Haislmaier, Senior Research Fellow, Health Policy Studies
The overriding reality behind this summit is that both the public and the politicians come to the table divided not over the details but rather over the basic approach to health reform. In his comments, Sen. Lamar Alexander (R-TN) highlighted three of those major divisions — comprehensive legislation versus incremental legislation, starting over versus pressing ahead with the bills passed in House and Senate in December, and a decentralized approach versus a centralized federal solution. Today’s debate showed few indications of a willingness by the President or the Congressional leadership to alter their basic approach. Though the summit served to highlight the fact that both parties are in favor of reform, differing only in their opinions on how to achieve it, the direction of the health care debate is unlikely to deviate from the course it has taken for the past year as a result of today’s discussion.
Nina Owcharenko, Deputy Director, Health Policy Studies
In order for the summit to have been successful, Democrats should have scrapped the House and Senate bills, along with the President’s proposal, all to which the American people have shown clear opposition. Simply adjusting the magnitude of these proposals or adding new “conservative” provisions as suggested in the President’s latest proposal does not change their fundamental direction.
As Yuval Levin has explained, the crucial differences between Congress and the nation at large are not differences in degree; they are differences in policy direction. Most Americans want problems in the health insurance markets fixed, but they do not want a federal takeover of the health care sector of the economy. Regrettably, the cornerstone elements of these proposals would put more power in the hands of Washington bureaucrats and politicians. Instead, Congress and the Administration should pursue bipartisan reforms that give Americans greater personal control of their health care decisions. If the President and Congress were sincere about achieving bipartisanship, they should have set aside these highly unpopular proposals and shifted direction by taking an incremental approach to health care reform: one that puts health care reform on a path toward empowering individuals and families to control more of the financing and delivery of health care.
James Capretta, Visiting Fellow, Health Policy Studies
The White House was hoping their summit meeting would create momentum among Democrats to push their bill through the Congress. That momentum almost certainly does not exist.
Nothing fundamental changed today. A strong majority of Americans is dead set against enactment of the bills Congress has been developing. They are rightfully concerned about the risks that a large and expensive new entitlement program will pose for future tax rates and deficits. They want Congress to go much more slowly and make sure that whatever is done improves matters and doesn’t make things worse.
At various points, participants admitted there is a fundamental difference between the sides on solutions. But they didn’t particularly describe the competing ideas very well. What it comes down to is this: what process can be put in place to improve the efficiency of the health sector. The Democrats believe in governmental management of costs. Republicans believe in a functioning marketplace. That’s why the summit is not very likely to produce much in securing common ground.
