14-9 and Still Counting

Sen. Baucus may have won a hotly contested playoff game, but a tougher divisional match and ultimately the championship still lie ahead. In the weeks and months to come, what the House and Senate produce will say as much about President Obama's political game and the legislature's resolve as it will about the fundamental American ethos. Since its inception and the framing of the Constitution, the American republic has been rooted in John Locke's theory of individual rights and shaped by competing Federalist views. We've espoused the mantra of limited government but with bipolar tendencies toward expansive federal programs (i.e., Social Security and Medicare). Historically, we've tolerated government incursions in health care but only when it concerned the purview of the deserving poor, disabled or the elderly.

On the other hand, our individualism has been tempered by a righteous sense of empathy and social fairness. Even so, the question lingers: are we ready to climb that proverbial Mount Everest of ideological shifts? Will we foray into that cultural tempest of universal coverage? Or will the heavy burden of government-sponsored anything scare us back into the arms of familiar traditions? At stake, will be a broken system and the millions of uninsured.

Indeed with the Finance Committee's 14-9 vote, the Congress undoubtedly inched closer to advancing what has been an arduous path to reform. Odds are some form of health legislation will pass, but whether the final incarnation represents substantive change, however, remains to be seen. The Baucus bill, the least politically offensive, won the coveted moniker of bipartisan, though barely. In exchange for a lone Republican vote and in the hopes of assuaging more conservative Democrats, Senator Baucus abandoned the public option. Instead he pegged health-care cooperatives and insurance exchanges as a viable alternative. These approaches, inherently weaker in nature, will unlikely wield enough leverage against an insurance industry, which in recent days has proved onerous and sadistic.

If individuals will be mandated to purchase health insurance then the public should be offered meaningful competition, which is best achieved through a more muscular government-backed option. The insurance industry and many others in the health-care sector are poised to reap an influx of potential customers. The Finance Committee proposed safeguards to protect ordinary citizens. It ensures guaranteed issue and caps annual out-of-pocket expenses. Rather, it concedes variations in premiums based on age, family composition and tobacco use. Ultimately, it leaves open the door for consumers to be bullied by gluttonous industry practices.

Throughout history we've acted out-of-character. Nixon, a limited-government Republican, proposed employer-mandated coverage in addition to a form of public option. Likewise, both Republican and Democratic administrations have tolerated a "backdoor approach" to universal coverage with incremental expansions of Medicaid. But yet again history is calling. And, if we follow the leads of FDR and Johnson we may be able to do something bold and characteristically American.

By Chris T. Pernell  |  October 13, 2009; 10:57 PM ET  | Category:  Employer health plans , Health Care Reform , Health costs Save & Share:                 
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