Republicans and the Health Care Pow-Wow

February 10, 2010

Some congressional Republicans want to turn down President Barack Obama's invitation for a nationally televised, Feb. 25 White House pow-wow on health care. They fear that if GOP leaders show up for the event, they will end up agreeing to a bad health-care bill in the name of bipartisanship.

Republican leaders should accept the invitation. The country rightly expects them to, even though it's a made-for-TV kabuki drama written, staged and directed by Mr. Obama.

It is also in the GOP's best interests. This is the party's best opportunity yet to contrast its good ideas with Democratic legislation.

Those ideas are far-reaching and significant. They include allowing small businesses to band together to get the same insurance discounts big companies get, passing tort reform to eliminate junk lawsuits that drive up the price of health care, and enacting reforms that would make health insurance portable for workers. They also include allowing people to buy health insurance across state lines, giving families the same health insurance tax breaks companies get, and empowering patients by making health prices more transparent.

By contrasting those ideas with ObamaCare, Republicans can give the lie to the White House charge that the GOP is the "party of no." For example, Republicans want Americans to be able to save more money tax free for health-care expenses. Democrats would reduce the existing amount that can be saved tax free, which this year is $3,050 for individuals, and tax people for using their savings to pay for over-the-counter drugs.

Mr. Obama will claim the legislation he wants would allow people to buy health insurance across state lines. But that's not exactly accurate. His approach is to allow states to do what they can already do: pass a law authorizing residents to buy insurance in another state. The problem is that this doesn't create a national market and, in any case, if Washington imposes mandates on what health insurance must cover, there won't be robust competition among insurers.

There are plenty of weaknesses in ObamaCare that Republicans can hone in on. They can point out that 10 years of tax increases and Medicare cuts pay for only four full years of new entitlements and that the projections for savings and tax revenues are based on gimmicks.

They can question whether congressional Democrats will actually cut Medicare by roughly $500 billion, as their bills call for. Why don't Democrats take up these Medicare cuts as a stand-alone bill? Passing such a bill would be a "confidence building measure," as Henry Kissinger might say.

Republicans can ask how Mr. Obama squares his pledge not to raise taxes on anyone making less than $250,000 a year with $20 billion in new taxes on medical devices and $80 billion on drugs. Even Congressional Budget Office Director Douglas Elmendorf has admitted in congressional testimony that these taxes will be passed on to patients.

Mr. Obama's demand that insurers be required to cover people with a pre-existing condition is problematic. Imposing such a mandate would encourage people to wait until they are sick to buy insurance when what we need to lower costs is more healthy people buying insurance. Mr. Obama would rope in the healthy by requiring that everyone buy health insurance or be fined. That mandate is very unpopular.

In a respectful but pointed tone, Republicans should question the special-interest provisions Democrats used to advance their bills in the House and Senate, such as exempting health plans provided to union members from a tax on Cadillac insurance plans. The public is already outraged by these special deals, and we may not yet know about all of them.

For example, commentators first thought only Florida seniors would be protected from cuts in government support for Medicare Advantage policies. But it turns out that Democratic senators in New Jersey and New York won similar protections for seniors in their states.

Mr. Obama's Feb. 25 meeting is not about hammering out a bipartisan consensus. It is part theater and part Chicago-style pressure politics.

It is also bluff and desperation. Mr. Obama knows the biggest obstacle before him is deep division within his party. That division is preventing the Democratic House from passing the Democratic Senate's health-care bill.

Republicans should remember they are near the end of the process rather than its beginning, when Mr. Obama's leverage was considerable. A year of his missteps have squandered a historically strong Democratic advantage on health care.

Americans don't like the health-care bills that have passed the House and Senate by a 58% to 38% margin in a new CNN/Opinion Research Poll and Gallup reports that 60% of Americans disapprove of the president's handling of the issue.

The public has made up its mind about ObamaCare. If Republicans prepare well, the pow-wow will be a chance to show Americans that the GOP has better ideas.

This article originally appeared on on Wednesday, February 10, 2010.

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