On multiple Sunday monring, George Will has suggested during his commentary on ABC’s This Week with George Stephanopolous that health reform would be easy if they just dropped all these demands and adopted “the Healthy Americans Act”–the Wyden-Bennett bill. The chief House sponsor is California Representative Anna Eshoo.
Senator Ron Wyden deserves a lot of credit.. at a time when President Bush reigned and health care reform was not in the national conversation, he aggressively pursued Republican Senators to see what they would support in a health reform package. His ability to bring on Republican Senators helped some start to believe that health reform was a live issue again.
Will says that there’s over 70 votes for the Wyden-Bennett bill, but it’s far from clear it would get such support from the left and the right of the Senate. It’s unclear if even all the 10-20 sponsors would vote for the bill, including the full financing and other aspects of the legislation.
Will has said that the major difference with the Obama plan is the public health insurance option. That’s a major difference, but it’s not the main objection. In his desire to get Republican co-sponsors, Wyden did not include a public health insurance option, even though he has said he’s not opposed to the concept. The bill is really less a bipartisan bill, than one to explore what Republican Senators would support.
But now we are in a different era, headed by President Obama, and the framework of a health plan he spent over $100 million promoting during the campaign. So politically, it makes sense to not abandon that electoral mandate for another framework, such as the Wyden approach.
I am skeptical of the Wyden approach of aggressively encouraging people into an individual insurance, however reformed. Proponents say it won’t be the broken individual market of today. But to the extent that the problem is that individuals simply won’t have the market power against the big insurers, some of the same problems will persist–even if the most obvious issues, such as people being denied for pre-existing conditions–will be thankfully outlawed. That’s why I would prefer the current approach by Congressional leadership of expanding group coverage–whether through employers, public programs, or otherwise. This also explains the rationale for the public health insurance option, giving consumers on more tool against the private insurers–namely, the ability to take their business elsewhere.
The reason why the Wyden-Bennett bill is still even talked about is that it got a favorable “score” from the Congressional Budget Office, an analysis that suggests that the plan would be revenue neutral.
But the way it gets to be budget-neutral should give consumers pause. It defines a basic benefit package, but allows the value of those benefits to degrade over time. Rather than raising the revenues needed to make sure the guarantee of quality coverage is there for consumers, the bill allows that assurance to become weaker and weaker. The point of health reform is to more broadly share the risk of rising health costs, rather than continue the existing shifting of risk onto patients and families.
The Wyden bill served it’s mission ably in kick-starting the health reform discussion nationally, well before Iowa caucuses and “Yes, We Can.” There may be provisions and lessons of interest, but the framework being discussed in the key committees in the one that President Obama ran on, and won on.