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OPINION
Barack Obama

Common Ground: A cure for health reform?

Bob Beckel and Cal Thomas
Supporters of the Affordable Care Act listen to President Obama give an update about his signature law at the White House on Tuesday.
  • CAL%3A Can centralized%2C bureaucratic government run a health care system that is one-sixth of the economy%3F
  • BOB%3A Republicans want to see Obamacare fail%2C even at the expense of people's health.

Cal Thomas is a conservative columnist. Bob Beckel is a liberal Democratic strategist. But as longtime friends, they can often find common ground on issues that lawmakers in Washington cannot.

BOB: Republicans in Congress want health care reform to fail. But they won't have HealthCare.gov to kick around as a political tool much longer. The Obamacare website repairs have been successful; 50,000 people can now use the website at the same time. The White House reports that more people signed up for Obamacare on Sunday and Monday than in all of October. President Obama is delivering on his promises.

CAL: Hah! As The Wall Street Journal notes, he's delivered unverifiable claims to give Democrats cover. Republicans don't want reform to fail, just this monstrosity that's making things worse. It's less about the website than access to the quality health care now available to most Americans. Quality will diminish as the newly insured flood doctors' offices and hospitals. We don't want the U.S. health system to suffer the British National Health Service'slong waits and unnecessary deaths.

BOB: High-quality health care is not available to millions of Americans who don't have health insurance, or whose substandard plans provide minimum coverage. That's why the Affordable Care Act is so important. It provides quality health insurance to both the uninsured and underinsured.

CAL: Agreed on unavailability, but even optimists acknowledge there will be tens of millions of uninsured when Obamacare is fully implemented. Troubles with the website are emblematic of a larger question: Can centralized, bureaucratic government run a health care system that is one-sixth of the economy? If government could do things efficiently, we wouldn't have a $17 trillion debt (and counting).

BOB: States that took responsibility for implementing the law, like California and Kentucky, have been successful. States controlled by Republicans that refused to take any responsibility for helping to implement the law forced the federal government to take over.

CAL: Many in these states are being shoved into Medicaid. Many doctors won't accept Medicaid patients because the reimbursements are too small. A study in The New England Journal of Medicine found that being added to Medicaid didn't actually make people healthier. Writing last week in The Wall Street Journal, William Galston, a Brookings Institution fellow, compared the rush to launch the Obamacare website with the haste to launch the Challenger in 1986 over the objections of engineers who predicted "a high probability of catastrophic failure." The Challenger exploded, killing all of the astronauts. If the Obama administration had waited until the website worked, we wouldn't be having this conversation.

BOB: I have worked with Bill Galston. He is a smart Democrat and completely right. The website launch should have been delayed. That would have avoided a lot of pain.

CAL: I'm amazed the administration didn't see this train wreck coming. As the president's job approval numbers decline and the public's faith in Obamacare collapses, wouldn't the smartest strategy have been to reach out to Republicans and ask them for help in rewriting the law? Or is that a naive notion with elections less than a year away?

BOB: The Republicans have done everything they could to cripple health care reform, and I don't think that will change. Republicans want to use Obamacare in the 2014 elections against Democrats who voted for it. They want to see it fail, even at the expense of people's health.

CAL: Government does few things well, and your faith in its ability to improve "people's health" is astounding. Now that Senate Majority Leader Harry Reid has gotten his way on the filibuster, I worry that the Independent Payment Advisory Board, whose members the Senate must confirm, will decide who gets care and who doesn't. Sarah Palin was ridiculed for calling it a "death panel," but former Vermont governor Howard Dean said, "The IPAB is essentially a health care rationing body." Same difference.

BOB: I'm surprised you think Palin knows anything about this law. The advisory board is charged with controlling health care costs by focusing spending on things that are proven to work instead of treatments that don't actually save lives.

CAL: A Washington committee can't know what the right medical choices are for me and my family. That's for me and my doctor to decide. The biggest jolts will come next year when Americans who have managed to sign up with Obamacare find out whether they get to keep their doctors, when the impact of the ACA on small business insurance plans becomes clear and big companies determine how their insurance programs will work after the employer mandate kicks in. That will give Republicans good prospects for a congressional sweep in the 2014 elections and the start of a workable solution to health insurance, if they don't blow it. You and I have agreed on central aspects of insurance reform, especially portability and pre-existing conditions. The two parties should, as well.

BOB: Using pre-existing conditions as a reason to deny health insurance coverage is banned under the new law. More needs to be done to ensure that employer-based insurance is portable. We also both agree that tort reform should be included to stop runaway lawsuits against doctors. But Republicans who see health care reform as a ticket to victory in the 2014 and 2016 elections are kidding themselves. The GOP health care reform plan is to replace Medicare with vouchers, but they are afraid to run on the idea for good reason. It's a terrible idea.

CAL: How about a bipartisan effort to cure expensive diseases, like Alzheimer's? That would substantially reduce health care costs and lower insurance premiums.

BOB: I'm with you on that.

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