Trying to be constructive, here's how I think healthcare could have been handled -- Chop it Up

[Armstead]

IMO the "health reform" bill looks to me like it is going to be a disaster. Rather than just bitch about it, though, I'll at least try to be constructive here by offering my own ideas about how it could have been handled.

I'm just another schlub, I realize, but here are the thoughts of one schlub. Please add your own thoughts and ideas or disagreements if you are so inclined.

No I wasn't expecting perfection. But I believe the approach they took will do more harm than good in several ways. It has poisoned the well for additional reforms, and it is so convoluted and confusing that it's almost impossible to be totally for it or against it. How many good things will be offset by rotten things?

So what could have been done differently? Here's my opinion.

If Democrats lacked the will (or circumstances) to actually promote a true single payer system -- or at least a strong public option available to everyone -- then I believe they should have taken an opposite approach.

Rather than lump together a whole bunch of stuff into one package, I believe they would have been more successful -- both in terms of positive results AND politically -- if they had taken an incremental approach. I don't mean wait another decade. But outline and introduce in succession a series of specific bills aimed at specific problems, with individual votes.

For example, almost everyone hates the denial of coverage for pre-existing conditions (except the insurance companies). IMO if the Democrats had proposed a bill that focused on that one problem and prevented the insurance industry from doing that, it would have had widespread support across the political spectrum....The GOP would have also looked like Scrooge to the "middle" (and even to some conservatives) if they tried to stop it.....(If necessary, it could also have been possible to include in the bill some kind of sop to the insurance industry, such as a subsidy for accepoting people with serious conditions.)

Likewise for many other ideas that are supported by a majority of reasonable people, such as price regulation and review of rates to prevent gouging.

In other words put health care on the agenda, and keep it front and center and keep pounding away at it -- starting with what is most popular and least "threatening."

Why do I think this focused approach would have been preferable? Aside from the obvious social benefits of actually getting things done to help people, here are some advantages (IMO of course)

1 I believe it would have allowed Democrats to have been more united. The ConservaDems could be more easily forced to go along (and they might do it willingly) for aspects of reform that are more widely accepted. We might actually look like a party of effective leadership and governance.


2) It would have made the whole concept of health reform more appealing. The smaller reforms would have made people less nervous about change, and would even whet their appetite for more. Doing the popular stuff, would also make it somewhat smoother and more effective to deal with the more controversial and harder elements subsequently. .....That would also, I believe, make it more likely to have gotten some form of meaningful government healthcare program in the foreseeable future. The Democratic politicians -- and the grass roots supporters -- could have organized and cultivated more support for a meaningful form of national health program, whether it be single payer or a "public option."

3) It would have made Republicans either go along, or look like complete a-holes if they opposed it. Right now, they can bring up all sorts of bogeymen about "socialized medicine" to "justify their opposition. But that would be a lot harder to oppose something like guaranteeing everyone access to coverage. The public would see them as the Grinch Party.

Those are just my thoughts.

[MH1]

1. I agree with your post

it's pretty much what I've thought all along. To be honest I never thought the republicans would allow Obama the huge win of real health care reform, and I don't think the Dems are skilled enough to get it through without at least some republicans (and because there's too many DINOs on this issue).

I really, really wish they would have quickly implemented the reforms that pretty much everyone agrees on, as quickly as they could.

But on the other hand, even if the current push ultimately fails, they now have republicans on record supposedly supporting certain things, and it might make it easy to get those small wins next year. Whereas without the big package to argue about first, the republicans might have just stonewalled everything that came along. (Universal healthcare is highly popular but the republicans have pushed back successfully against it. Why would pre-existing conditions rules be any different?)

[Armstead]

2. The democrats could have been united enough to make the GOP irrelevant

The Big Obstacle is supposedly the threat of a veto. If that were removed on proposals that the Conservadems could go along with, then the GOP would not matter....And like I said above, they'd look like jerks for opposing popular reforms.

Universal single-payer health care is trickier, because that can be (falsly) attached to the bogeyman of "socialism." But, IMO, if people start seeing positive benefits of lesser reforms, they would be more inclined to support some form of meaningful government program.

[LiberalAndProud]

3. Yes. They need to cut it up.

Pre-existing conditions and lifetime caps could have been dealt with in February. I haven't heard a single politican to speak out against those two planks of reform. Why do we have to tackle the whole mountain in one gulp? 2000 pages of ... what? Nobody knows, not even the people who wrote the thing.

[BeyondGeography]

4. Being another schlub, I have my doubts

The legislative process being what it is, I don't think you could have had a controlled, single-issue approach. Isolate insurance co. treatment of pre-existing conditions? Well, that's going to raise costs for the poor insurance co's, so how are you going to pay for it? If you want A, then you have to concede B or C or both. Before you know it, you're talking about a lot more than pre-existing conditions. And if you think the single-issue approach would isolate Republicans, look how many Democrats in the Senate are capable of feeling the pain of insurance companies. Seems to me you put more pressure on the Republicans and the conservadems by tackling the whole beast at once.

[Armstead]

5. Alas it would never be totally easy -- but a lot more managable imo

You make a good point about the implications of pfre-existing conditions. It would take some wrangling and bargaining.

But my point is -- in comparative terms -- it would have been a lot more managable and constructive process and result if it were not also being debated in the mire of many other unrelated issues. As I said, there could have been compromises to deal with the consequences without giving away the store.

[Armstead]

6. Kick -- I guess "trying to be constructive" isn't as interesting as flame bait

[MH1]

7. Heh, I know

you aren't just figuring that out now. :)

[Armstead]

8. Oh no....Plenty of experience with that...But hope beats eternal

[Armstead]

9. kick