The Republican roots of health reform

The unanimous rejection of health reform by GOP Senators and Representatives, the "repeal and replace" rallying cry, and the venom and violence directed against some health reform supporters make it seem that the new law is a radical, left-wing overreach that will soon be repudiated by the electorate. And yet the law is modeled on the plans of Republican Governors Mitt Romney of Massachusetts and Arnold Schwarzenegger of  California.When the dust starts to settle it will be hard for opponents to develop a realistic, mainstream alternative that they can rally the country around.Leif Wellington Haase makes this argument on the New American Foundation's New Health Dialogue blog (HEALTH REFORM: A Modest Revolution). He adds some good points:

  • The law is more modest and gradual than the Clinton plan, "which envisioned regional health alliances, premium caps, and the eventual eclipse of employer-sponsored care"
  • The law's individual mandate is a Republican-inspired idea, compared with alternatives such as single-payer and employer mandates
  • Cost control will be a challenge, but the law is likely to have a greater impact in this arena than most give it credit for. These include:
    • An excise tax on high-cost plans
    • An independent Medicare advisory board
    • The Medicare and Medicaid innovation center
    • Tests of bundled payments, accountable care organizations, and non-payment for errors and avoidable readmissions

In Haase's view --and mind-- the key is to get the private sector to believe that cost control is the wave of the future. Once that's in place, private innovation will accelerate the cost control process beyond what the government is capable of.

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