There is talk among Democrats and Republicans about splitting up the healthcare reform bills. At this stage, that makes sense. I think we can accomplish the most needed and best parts of the President's proposal in parts 2 andd 3 with 70 votes, including Respublicans. That leaves part 3 for contensious debate.
Part 1 simple/obvious - End barriers to coverage for people with pre-existing medical conditions and prevent insurers from dropping or raising rates on sick people. You could add improvements for quality of care & patient safety. Also, end the eliminates the "out of network" scam no one seems to talk about. If the same company covers a doctor in Maine, that doctor is in your network even if you live in California (this would set the stage nicely for a national public option). This has wide American and even Republican support. Newt, McCain and others have supported some of these ideas. The only opposition is from the insurance companies, of course, but it would be hard for them to fight something so common sense.
Covered parts from Obama's proposals:
Invest in prevention and wellness (insurers could no longer depend on dropping people when they get sick would be forced to invest in prevention)
Improve patient safety and quality of care
End barriers to coverage for people with pre-existing medical conditions
Part 2: Improve Medicare/Medicaid (A.K.A. the rise of the Public Option)- Certainly, the program could use some tweaks. Throw in the ability to negotiate drug prices. Then, as Dr. Dean suggested, open it up to the public who want to pay for their own service. Showing how at present rates, this would strengthen the programs while proviing more competitive choice would be great. You'll have American support, but probably only just enough Democratic support to pass.
Covered parts from Obama's proposals:
Reduce long-term growth of health care costs for businesses and government
Guarantee choice of doctors and health plans
Part 3: Costs and coverage: this is the part that won't happen without a fight. This part wiould include putting mandates on business (or citizens which seems stupid to me)for coverage, subsidizing insurance for most of the un-insured, and specifically those on unemployment indurance
Covered parts from Obama's proposals:
Protect families from bankruptcy or debt because of health care costs
Assure affordable, quality health coverage for all Americans
Maintain coverage when you change or lose your job
While we certainly want all of the things that go along with part 3, I think it would be acceptable to trade parts 1 & 2 for 3. The mandates would be a boo for the insurance industry, so they would support that part. That might be enough to get it through. Meanwhile, the very real fear of unsustainable increased to our debt could be argued fairly. In addition, new options like adding COBRA health care coverage to unemployment insurance could be discussed. That right there could be done by taxing the uber-rich and would cut the uninsured by at least a third.
This way, Obama could gain "momentum" by getting the first two passed. That would translate to better approval numbers for him and Congressional Democrats and put us in much better position come next year.
Do you agree? How would you split it up?