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The Next Chapter of Health-Care Reform

It is not clear whether anyone has the stomach for more health-care negotiations.  For the Democrats, it would be like revisiting the site of a traumatic auto accident. It is where the pain started, and it will only remind voters where the Democrats got off course. Republicans might just as soon move on to other issues rather than throw Democrats a lifeline. But there are good reasons, both substantive and political, to move forward.

As the Washington Post editors counsel, now that ObamaCare is “in mortal danger, President Obama should try treating the Senate Republicans the way he treats the ruling mullahs of Iran.” In other words, try to engage and give the other side every benefit of the doubt. More seriously, the Post notes that Republicans have some good ideas. (“Tort reform, freedom for state experimentation and other issues could advance Mr. Obama’s goals of increased access and decreased costs.”) In short, we might actually get a coherent, effective piece of legislation now that the monstrosity cooked up by Obama-Reid-Pelosi is kaput.

In a similar vein, James C. Capretta and Yuval Levin urge Republicans to move forward on three fronts:

First, they should seek to address the problem of insuring Americans with preexisting conditions through state-based high-risk pools, not cumbersome insurance regulations that try to outlaw basic economics.  … Second, they should propose to help doctors and patients limit some of the burden of rising costs with medical malpractice reform. … Third, they should argue that the states be given the lead role in developing more detailed reforms of how and where people get their insurance—to cover more people and slow the rise of costs. The overall goal should be to build well-functioning marketplaces in which insurers and providers compete to deliver the best value to cost-conscious consumers. The federal government should remove bureaucratic obstacles to state experimentation on this front, and offer support where possible, but not design one mammoth new program.

Well, it sounds like they and the Washington Post editors could hammer something out in an afternoon. But alas, the same crew who came up with ObamaCare would be negotiating with the Republicans, so we shouldn’t get our hopes up. Nevertheless, as a political matter, it makes sense, if not now then in a couple of months, for both Democrats and Republicans to give it a try. Democrats don’t want the last chapter of health-care reform to be the Cornhusker Kickback and the mandate to make everyone buy policies they don’t want from Big Insurance. And Republicans, who are auditioning for control of Congress, want to show what real reform looks like and how the “party of no” was another liberal fable cooked up while Democrats were trying to convince voters the choice was between ObamaCare and nothing at all. (The voters liked the “nothing at all” option better.)

It is understandable if lawmakers would rather move on. But given that there isn’t too much agreement on anything else (immigration, cap-and-trade), they might give health-care reform one more shot. They really can’t do worse than they did the first time.



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