It's Time to Make a Deal

Thursday, 04 Mar 2010 04:49 PM

By Lanny Davis

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In last Saturday’s national radio address, President Barack Obama said he is ready to compromise with Republicans on healthcare but is not satisfied with doing nothing. “Let’s get this done,” he said.

At the healthcare summit last week, and again on “Meet the Press” this past Sunday, Arizona Republican Sen. John McCain said he would support passing a bill this year as long as it was a “new” compromise, not one that merely tweaked the Democrats’ current proposal for comprehensive reform.

It’s not too late to do this — even though President Obama has already apparently adopted several GOP ideas in his latest proposal.
Let’s take both men at their word. Here’s my specific proposal:

President Obama and Sen. McCain should meet — alone, not on C-SPAN — and try to reach a brand-new compromise agreement first.

In 2008, they ran against each other — and, with few exceptions, ran one of the most dignified and mutually respectful presidential campaigns in modern U.S. history. If each man can reach agreement on a compromise in private one-on-one talks, I believe Obama can persuade his undoubtedly unhappy liberal base that this is a first and meaningful step on a long journey to achieve reform.

However, this first step must be achieved this year, after all this time and effort, or there could be a real danger of losing both houses of Congress in November.

Meanwhile, I believe McCain can persuade at least a significant number of the more public-spirited conservative Senate and House Republicans — and there were many who impressed me as such who spoke at the summit and at the president’s earlier appearance before the House GOP conference — to enact the legislation by 70 or more votes in the Senate and 275 or more votes in the House.

Here are the five core goals for healthcare reform I believe are generally consistent with Obama’s stated positions:

1. Significant reduction of the number of the uninsured;

2. Significant reduction of the number of those who can be denied coverage due to pre-existing conditions;

3. Reduction of costs via reduction in waste and fraud and via fundamental reforms in the system;

4. Establishment of Internet-accessible state “purchasing exchanges,” encouraging maximum competition between insurance companies by allowing consumers easy comparison on terms and pricing;

5. No increase, and possibly reduction, in the deficit over at least the next 10 years, which would require increased taxes.

The differences between these five Obama goals and those McCain would likely propose and be able to sell to many fellow conservatives in Congress may come down to just four issues:

First, the meaning of the word “significant” in the total expansion of coverage to the uninsured and the willingness to increase taxes to pay for such expansion.

Congressional Republicans have already proposed a plan that would extend insurance to approximately 4 million people who are uninsured, versus the Democratic number of approximately 33 million people. But congressional Republicans (including McCain) will not support any tax increases to do so — a position apparently supported by most voters, especially independents, according to most polls.

The compromise to make considerable progress to covering the uninsured may be for Obama and McCain to agree on splitting the difference — say, to extend insurance to approximately 18 million more people (or more than half of the currently uninsured) — with Obama paying for the costs of that extension from the various savings the Congressional Budget Office has scored in the current Democratic proposal.

On mandatory coverage with pre-existing conditions, at least some Republicans, such as Sen. Lamar Alexander (Tenn.) at the summit, have said they favor some way to address this issue, and apparently some states already do by regulation. Obama and McCain should be able to agree on a base standard for state regulation to minimize denial of coverage due to pre-existing conditions.

The president has already indicated an open-mindedness to a competitive national, rather than a state, insurance exchange. One idea that would strengthen the fairness of a national system would require that every state offer at least the same lower-cost Blue Cross Federal Employee Insurance Benefit Program that is available to every federal employee and member of Congress.

On the complicated issue of tort reform, perhaps the best compromise for now would be the same type of bipartisan blue-ribbon commission Obama has just established for budget reform.

And there you have it — voila! — an incremental healthcare reform package that could and should win bipartisan support from 75 or more votes in the Senate and 275 or more in the House.

At the very least, if Obama proposes such a conservative-tilted compromise measure and Senate Republicans still block an up-or-down vote with a filibuster, the American people would more likely support congressional Democrats using budget reconciliation procedures to enact this compromise — or even the Obama-Democratic comprehensive proposal — by a simple majority Senate vote. And come the November elections, such an outcome could provide an advantage to the Democrats as the party that truly tried to compromise with Republicans, as polls show that public overwhelmingly favors; and disadvantage congressional Republicans as the “just say no” party of naked partisanship.

Mr. Davis, a Washington D.C. attorney, was Special Counsel to President Clinton from 1996-98 and a member of President Bush's Privacy and Civil Liberties Oversight Board from 2006-07. He is the author of "Scandal: How 'Gotcha' Politics Is Destroying America" (Palgrave Macmillan, 2006)


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