Last week, President Obama stood in front of Republicans in Congress and effectively dared them to propose superior healthcare reform policy. After several bruising losses in elections, Democrats have striven to portray Republicans as the "Party of No", a party that simply opposed any Democratic policy without providing any solutions of their own. With only one Republican in the entire Congress voting for either version of the bill, that portrayal was relatively simple to create. Surely they did not believe the current health insurance situation was perfect.
Now, top House Republican John Boehner has called his bluff. He recently announced an alternative GOP plan for healthcare reform. According to Boehner, his party's bill will do more to reduce the cost of health care while preserving Medicare and avoiding higher taxes or deficit spending. He also highlighted the fact that Republicans have had their own proposal for months, but that it has been ignored in favor of intra-party squabbling among Democrats.
Indeed, Republicans in the House of Representatives do have legislation to provide more Americans with health insurance. Compared to the Democratic plan, it is far less expensive. The nonpartisan Congressional Budget office estimates that it would cost only $61 billion over 10 years. By contrast, the legislation passed by House Democrats had a price tag of more than $1 trillion for that time period. The Senate's version comes in at just under that mark. Part of the reason for the lower cost is that there are no insurance subsidies involved. In addition, the health insurance mandate (which would require most people to buy a policy) is absent. That is to be expected, since that provision has been deemed very controversial, and even unconstitutional in some quarters. A group of Republican Attorney generals have threatened to sue the federal government if a mandate passed. If this Republican-led reform passed instead, their concerns would be a moot point.
In keeping with their pro-business stance, the Republican bill includes less regulation of health insurance companies than either Democratic bill. It is also said to include provisions several Republicans have proposed in the past. Instead of creating a nationwide regulated health insurance exchange market to promote industry competition, Republicans believe it is a better idea to lift restrictions on inter-state sales of individual health insurance. Certain states have more restrictions on coverage, such as requiring medical insurance companies to cover various health conditions. For example, some states mandate that all health insurance plans sold within their borders offer mental health coverage, while others don't. In many cases, self employed health insurance is more expensive in those states that require more comprehensive coverage. If interstate insurance sales are allowed, people will be able to buy the individual or student health insurance that provides the level of coverage they need: no more, no less. This will allow them to shop around and save money.
Obviously, medical malpractice reform is also a significant part of the legislation. Rather than vilify health insurance companies, Republicans prefer to blame trial lawyers for rising health insurance costs. Without stricter caps on the amount of money that can be rewarded in medical malpractice cases (especially those decided by juries), physicians are forced to practice defensive medicine: in other words, they must perform multiple tests and procedures that are medically unnecessary. Otherwise, they leave themselves open to lawsuits if something goes wrong. Many doctors have ceased to practice because of the millions of dollars in malpractice insurance they are required to have against judgments. A lack of practicing doctors, especially primary care physicians, results in those remaining increasing their rates. Those costs are passed onto the public in the form of individual health insurance premiums, leaving millions of Americans uninsured because they cannot afford to buy it.
Even in their weakened political position, Democrats are unlikely to consider the Republican bill. Some are skeptical that it would serve as real healthcare reform: although it will have a far smaller impact on the deficit, it also has less reach and effectiveness. The Democratic plans are predicted to provide access to health insurance for 30 million Americans; the Republican plan will only cover 3 million. Excluding undocumented immigrants (who are not covered in either party's proposals), many Americans will still be uninsured. Another issue remains: will the public be any more interested in GOP healthcare reform than it is in Democratic reform? An increasing portion of our population is weary of the debate altogether.
