Sen. Mark Begich, in a speech to a packed ballroom at the Anchorage Chamber of Commerce meeting Monday, showed that he is strong on the basic elements that health care reform must include but he is unfortunately vague on two important questions. He realizes health care reform should be designed to rein in out-of-control spending. Trying to prevent unhealthy conditions should be emphasized as part of that cost-cutting.
Sen. Begich supports fixing the fundamental problems with today's private health insurance. People should not be denied coverage because they are already sick. People should be able to change jobs and still keep insurance. People should be able to keep their current insurance plans and doctors if they want to. He also knows that small businesses need special help if they are going to provide health insurance for their employees. Sen. Begich gets another important point: Along with covering people who are now uninsured, health care reform should expand the work force of professionals who will provide the expanded care. One key way to do that, he notes, is to allow physicians assistants, advanced nurse practitioners, dental health aides and others to do more work that is currently done by doctors or dentists.
On two critical points, though, Sen. Begich has yet to say what approach he favors.
• How we should pay for universal coverage? Tax increases for the well-off? Taxes on especially generous health insurance benefits? We didn't hear any ideas from Sen. Begich in answer to a question from a member of the audience. He said health care reform shouldn't add to the deficit but didn't say how to accomplish that. It's a question that must be answered. To be fair, the Senate Finance Committee is still grappling with the issue too.
• What mechanism will be used to make affordable health insurance available to everyone? Begich noted there are two ideas afloat -- creating some sort of co-operative that would let individuals and families buy coverage at much cheaper group rates, or establishing some sort of government insurance plan that people could buy into. The government plan would compete with private insurers.
Begich did say he likes the idea of opening up to the public the insurance plan that covers federal employees, including Congress. Because they are a giant pool of people, it gets good rates. "Let people buy into it," Begich said.
But he also said in a recent interview that he is open to the idea of a cooperative.
Sen. Begich is deeply engaged in the debate. He has devoted a staff member to health care bills, though he is not a member of any of the committees working on reform bills. He was part of a group that met with President Obama on the topic. While we'd like better defined opinions from Sen. Begich on paying for reform and making health insurance accessible for everyone, his views on the basic notions that should be included in health reform are sound. As he is a member of the majority party that is pushing for reform, and an Alaskan, his voice is critical.
BOTTOM LINE: Sen. Begich's views on the goals of health reform are solid. We need to hear more from him on how to achieve them.