SPECIFIC GOALS
Some specifics of what he would do:
• Outlaw the denial of insurance coverage because of pre-existing conditions.
• Make it illegal for insurance companies to drop or cap coverage when people get sick.
• Build on the existing employer-based insurance system by requiring medium-sized and large employers to provide coverage (while exempting 95 percent of small businesses).
• For those still without coverage, create a national exchange where individuals can buy reasonably priced insurance, and require that everyone get it -- the system only works if everyone buys in.
• Control costs by reducing waste and improving efficiency.
REPUBLICAN IDEAS
The president favored at least a couple of Republican ideas, attempting to get past the partisan bickering that has characterized the debate.
He proposed demonstration projects to test the contention that reforming medical malpractice laws will reduce the cost of medicine. Some doctors say they practice "defensive medicine," such as ordering extra tests, to avoid potential lawsuits.
And he endorsed Republican Sen. John McCain's idea that the federal government should immediately offer low-cost coverage for serious illness to Americans who can't get coverage because of pre-existing conditions.
Altogether, the president articulated a fine vision, one that takes the same general direction as some of the bills already being written in congressional committees. But the challenge remains to fully convert his vision into legislation that will accomplish it.
PAYING FOR REFORM
Obama put the cost of his proposal at $900 billion over 10 years. Can that much be saved by reducing waste and inefficiency in two existing, huge government plans, Medicare and Medicaid? That's what Obama is counting on to pay for "most of this plan." The rest, he said, would come from drug and insurance companies, which will benefit by the growth in insurance customers. If the savings don't materialize, Obama supports a mechanism to enforce offsetting cuts in federal spending.
Counting on efficiencies to pay most of the cost is speculative and highly optimistic. Nonetheless, everyone should agree that something must be done to reform the health care system. The current state of affairs is not sustainable. Making changes does entail downside risk, no question, but doing nothing only postpones the inevitable need to act, making the crisis ever more urgent and more difficult.
APPEAL TO OUR BETTER NATURE
President Obama appealed to Americans' better nature. It is part of the American character to recognize, "We are all in this together," Obama said, "that when fortune turns against one of us, others are there to lend a helping hand."
That's really what the health care debate is all about: making sure that affordable health care is available to every American. We can only do that if we get a handle on the out-of-control costs of our current health care system and broaden the access.
Successful health care legislation doesn't need to track the president's plan in every aspect, but his speech offered a clear direction and a reasonable start on how to pay for it.
BRIDGE THE PARTISAN DIVIDE
We would like to see Republicans in Congress accept the invitation to be actively involved in shaping the final reform package. Democrats should give their ideas fair consideration and incorporate them where they contribute to the ultimate goal.
Critics who argue to do nothing should be ignored. If we are persuaded to perpetuate the status quo, we will live to regret it.
Congress has taken up health care reform many times, but has never been this close to passing a health care overhaul. We shouldn't let the opportunity slip by now.
BOTTOM LINE: Congress should debate and refine the president's ideas, then pass a bill that accomplishes his major objectives and provides a credible way to pay for them.
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