Commentary Magazine


Mini-Healthcare Reform

Michael Kinsley makes a useful suggestion on healthcare reform:

Why doesn’t the president give himself a well-deserved treat and slow down a bit on health-care reform? Instead of going for a total overhaul, go for some smaller successes, or what business executives and gorillas call the “low-hanging fruit”? Pick half a dozen, get Congress to swallow them and see where we stand?

And his first low-hanging fruit — malpractice reform — is a fine idea. Unfortunately, next to Big Labor there is no group Democrats are more dependant on than trial lawyers. So we can pretty much cross that one off the list. Next on his list is “eliminating paperwork.” Again, a good idea. But are we to have a Federal Czar of Paperwork enforce the new rules? I can hardly wait for the volumes of regulations on eliminating paperwork. Next is “outcomes research.” That is a nice way of saying “rationing by bureuacrats.” We’ve seen how this turned out in the U.K. and elsewhere. And lastly, Kinsley says we over-use ambulances and emergency rooms, which may be true but the fix is harder than it seems. (Charge poor people for calling an ambulance they don’t need?)

Kinsley’s conclusion is nevertheless correct if you favor sweeping healthcare reform: “There are two risks in comprehensive health-care reform. One is that it won’t pass — and a second failure would doom the project for decades. The second is that it will pass but won’t work.” And if you oppose healthcare reform as too expensive and unlikely to produce beneficial results, then you too would prefer some “smaller” reforms, which would be far less expensive and damaging than the grandiose plans making their way (or not) through Congress.

So although it isn’t easy to come up with a list of mini-reforms that is both politically feasible and effective, it may be worth a try. At least, small and ineffective measures won’t entail massive taxes or a takeover of 17% of the economy. And if significant malpractice reform is really on the list, then we might find Republicans flocking to support it. But don’t hold your breath waiting for such offer to materialize.

What is the president up to? He’s in full straw-man and ad hominem attack mode. He decried un-named “special interests” from overseas:

President Barack Obama said Friday as he left an international summit in L’Aquila, Italy, that he believes a health care bill will pass Congress this year, but said “special interests who profit from the existing system” are actively “scaring people.”

“I’m confident that we’re going to get it done,” the president said at a news conference before he headed from the G-8 to an audience with Pope Benedict. “I think it’s going to get done. It is going to be hard, though. … As dissatisfied as Americans may be with the health care system, as concerned as they are about the prospects that they may lose their coverage or their premiums may keep on rising, they’re also afraid of the unknown.

And we have a long history in America of scaring people that they’re going to lose their doctor, they’re going to lose their health care plans; they’re going to be stuck with some bureaucratic government system that’s not responsive to their needs. And overcoming that fear — fear that is often actively promoted by special interests who profit from the existing system — is a challenge

But just who is he attacking — his own Blue Dog Democrats? Senators like Joe Lieberman and Kent Conrad who reject the public option? Really, if we are going to get either big or mini-reform on health care, must we not end the “politics of personal destruction” and “move beyond the bitterness and pettiness and anger that’s consumed Washington“?

Maybe the president should take up his anger with the House Democrats. They and their Senate collegues seem not to have gotten the message that anyone who opposes him is “scaring people” and defending the “existing system.”