Next month, Michael Moore's new film, "Sicko," will debut, focusing media attention on the problem of health care in America. Voters — liberal or not — will hear the message: Health care in America is a disaster, and we need to fix it.
Hillary Clinton, Barack Obama, and John Edwards will, of course, be waiting in the wings to tell us just what to do about this sorry state of affairs. Though each candidate will offer variations on a theme, in broad-brush terms, they will all propose rolling out socialized medicine in some form.
It's a solution that Americans seem to embrace and reject in equal measure. In a recent CBS poll, 64% said that government should guarantee health care for all, and 65% said that this objective was more important than keeping health care costs down. Yet, in a recent Harris Interactive-Wall Street Journal poll, 74% said that they favored less "big government" methods of reforming the health care system: employer mandates, subsidies for the uninsured, and tax credits to help individuals purchase insurance. Only 26% supported expanding funding for Medicaid and Medicare to cover more people.
Next month, Michael Moore's new film, "Sicko," will debut, focusing media attention on the problem of health care in America. Voters - liberal or not - will hear the message: Health care in America is a disaster, and we need to fix it.
Hillary Clinton, Barack Obama, and John Edwards will, of course, be waiting in the wings to tell us just what to do about this sorry state of affairs. Though each candidate will offer variations on a theme, in broad-brush terms, they will all propose rolling out socialized medicine in some form.
Even if voters seem conflicted as to what kind of solution they want, health care is a big deal in the mind of the average American. The same CBS poll mentioned above showed that health care was as major a concern to voters as jobs and the economy. So, it's little surprise that Americans may be looking for a solution — even a bad one — to the dilemma.
The thing that is shocking is that while both major parties can credibly speak to much of the electorate on jobs and the economy, only one party has the trust of American voters where health care is concerned, and that is the Democratic Party.
Despite the fact that the CBS poll indicates that voters are uneasy with the plans being put forward by Mrs. Clinton, Mr. Obama, and Mr. Edwards, Republicans seem incapable of getting voters to trust them on this issue. Perhaps it's because, by and large, they aren't even trying.
Sure, under President Bush, we've seen the introduction of Health Savings Accounts and the Medicare Part D prescription drug benefit. But the former are little understood and the latter, well, it was in essence a Democratic idea, anyway. The only other prominent Republicans to talk about health care in any meaningful way have been Mitt Romney and Newt Gingrich.
Mr. Romney, while governor of Massachusetts, formulated a plan which now appears riddled with practical, fiscal, and philosophical problems. Its premiums average around $400 per person, per month; it is running vastly over-budget already (due to subsidies for expensive insurance for poorer Bay Staters), and it achieves 100% insurance by virtue of imposing criminal sanctions for those who fail to purchase insurance.
Mr. Gingrich, policy wonk extraordinaire, has offered a different set of solutions, including health care coordinators and RHIO Wikis — whatever they may be. And therein lies the problem with Mr. Gingrich's ideas: too much wonkery, too little clarity.
At the end of the day, both Mr. Romney and Mr. Gingrich get an "A" for effort. But unfortunately that's not the same as an "A" for performance.
In order to keep Republican primary voters on board, and attract the support of health care-concerned voters in the general election, Republicans need to start coming up with policies that will deliver, and will do so without looking like HillaryCare-lite.
How to do that? Above all, Republicans need to get back to first principles where the health care debate is concerned.
Since excess regulation contributes greatly to skyrocketing costs — which in turn makes it tough to buy insurance if you're among the working poor — rather than proposing more regulation, Republicans might consider pursuing deregulation of the insurance market.
In Connecticut, it is possible for a 30 year-old to buy catastrophic coverage for about $50 a month. Sadly, in neighboring Massachusetts, that insurance cannot be bought or sold, because it does not cover things like acupuncture and chiropracty, as is required by law. The same is also true in many other states. Yet it would not be if Rep. John Shadegg's and Senator DeMint's Health Care Choice Act were passed. This bill would eliminate barriers to interstate commerce in the realm of health insurance, increase competition in the insurance market, and drive down prices.
Republicans should also consider a proposal put forward by Senator Coburn, which would offer a tax rebate of $2,000 per individual (and $5,000 for a family) to buy health insurance. With health insurance for some families in this country costing upwards of $10,000 a year, it's a safe bet that when combined with deregulation, Mr. Coburn's act could prove very valuable, especially to the working poor.
Yet another option would be to allow small businesses to pool together to buy health insurance, as Senator Snowe has advocated. Given that roughly 60% of America's uninsured are employed by small businesses, the implementation of such a plan could offer a solution to many of those who see getting and keeping health insurance as an intractable problem.
Whatever the course, one thing is clear: In the next year, Republicans have got to start doing something big and principled to chip away at the Democrats' dominance on this issue. Otherwise, the day after the 2008 election is going to feel a lot like the dreaded annual physical.