Saturday, December 22, 2007

Washington Post: McCain "Has Some Good Ideas on Health Care"

The Washington Post is not known for favoring Republican prescriptions for health care reform. That is why their editorial today calling the McCain health care reform proposal, "the most detailed and thoughtful of the Republican proposals," caught my eye.

McCain has gone further in some respects than his Republican opponents on health care. Instead of providing people with a tax deduction, McCain converts the same tax savings into tax credits which will do more good for people in the lowest tax brackets--lower earners who need the most help.

McCain also puts more emphasis on cost containment--albeit with a focus on "coordinated care" that the provider community has tended to resist. "Coordinated care" may have a logic to it but McCain needs to also tell us why the providers will be willing to play ball with him when they have generally rejected the market's attempts to do the same thing.

The Post also rightly points out that the McCain health plan is weak on how he would use a more vibrant market to offer coverage to everyone just as his plan grants more flexibility to a market known for "cherry picking" when the rules aren't there to prohibit it.

McCain has always struck me as a Senator who is willing to work with all sides to find a common sense solution to problems even when that means moving off his party's ideological base and creating political problems for himself.

McCain worked with Ted Kennedy on the failed "patient rights" bill of the late 90s--which largely failed to pass only because the market adopted many of its requirements and undercut the need to do it. McCain's efforts on the tobacco settlement also crossed party lines to get a deal done. And, his efforts on campaign finance reform and the failed immigration reform (in tandem with his President) all point to someone who is going to find a solution even if it means doing business with political opponents--and at great cost to his own political support.

If we get a Republican President, health care reform is only going to be possible if that Republican is able to work with Democrats. If, as we now expect, Democrats control the Congress that will be essential if we are to avoid more gridlock. Even if the Republicans capture one or both of the House or Senate, it will still take plenty of Democrats to get anything as big as health care done.

One can also argue that Governor Romney shares the ability to work across the aisle since he did the deal with his Democratic legislature to do Massachusetts health care reform. However, the fact that Romney seems to deny that role on alternate days when it suits his audience doesn't give me a lot of comfort.

McCain has certainly shown that pragmatism and may be the real reason he got somewhat of an endorsement today by The Washington Post.

You can access my review of each of the major candidates' health care reform plans in the column to the right.


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