The strong repudiation the Democrats suffered last week is undoubtedly due in large part to voter discontent with the less-than-successful policies President Obama and the Democrats have implemented to improve our economy, and with the health care legislation they passed this year.
However, with the Republicans in control of the House and a tightening in the Senate, it will no longer be on just the Democrats’ shoulders to find ways to lift our economy from the grips of the recession, and to improve our complex and costly health care system.
A recent Rasmussen Reports poll shows that a majority of voters (53%) favor repealing the health care law, and 46% say it is at least somewhat likely that the law will be repealed. It is clear that the next Congress will at the very least have to reform and reconfigure the health care sector as repeal, however attractive it is to many in the Republican Party, is not a viable alternative, given the certainty of a presidential veto.
What then, should be done?
In reforming the current law, both parties must first recognize the essential elements of the current health care bill that are both popular and beneficial.
One area in which substantial progress has been made is in insurance reform. Thanks to the health care bill passed this year, insurers cannot take away health care coverage when someone gets sick. Additionally, families can get free preventive check-ups with their doctor, and the age young adults can stay on their parents' insurance plan has been extended. For seniors, the “doughnut hole” in Medicare prescription drug coverage will begin closing in January -- and it will be completely eliminated by 2020. And in 2014, insurers will be prohibited from denying coverage to patients with pre-existing conditions.
All of these reforms are not only popular but, more importantly, they are long overdue. Democrats in particular should highlight these aspects of the bill, and be prepared to consider interstate purchasing of insurance to further drive down costs.
To that end, Democrats must be honest about where the bill falls short in this regard. The bill fails to address the issue of cost-containment at a time when the American appetite for fiscal conservatism is stronger than ever. The public doesn’t trust the federal government to keep costs down while preserving quality care; just 37 percent believe the government is more capable than their insurance company of doing this, according to a recent Rasmussen poll.
Thus, the parties must come together to develop cost containment strategies that won't come at the expense of patient choice. One cost-containing strategy that was put into the health care bill that needs to be reformed is the Independent Payment Advisory Board (IPAB). IPAB’s role is to cut Medicare costs with minimal congressional intervention. However, there are few checks on IPAB's power, and thus it is of great concern that IPAB could wind up cutting costs in ways that compromise patient care. Democrats and Republicans alike must call for checks to be implemented on IPAB to ensure patient choice.
Another well-intentioned measure that aims to ultimately help cut health care costs is funding for medical research to compare the effectiveness of medical technologies. Last year’s stimulus bill included more than $1 billion for such research. While this idea is great in theory, there are concerns that the result of such research will lead to irresponsible cost-cutting that will also lead to cuts in necessary coverage. Congress should work to implement provisions that guarantee that this research will not provide justification for insurers or public programs like Medicare to drop coverage. Good medicine depends on good science, and fears of medical rationing must be put to rest.
Health care costs do need to be contained. Too many Americans -- 40 percent -- say they have forgone filling a drug prescription because of the cost, according to a recent Rasmussen poll. And nearly the same number -- 39 percent -- say they have postponed a medical procedure or checkup in the past six months to save cash.
Thus, Democrats and Republicans must come together to find solutions to reform the health care bill that demonstrate their commitment to fiscal responsibility by focusing on cost containment, while keeping in place patient choice.
Douglas Schoen is a political strategist and author of the just-released book, "Mad as Hell: How the Tea Party Movement is Fundamentally Remaking Our Two-Party System" (Harper 2010), co-authored with Scott Rasmussen.