NJPP Monday Minute: 1/25/10 Health reform at the crossroads

The stunning upset pulled off by Republican Scott Brown in the Massachusetts US Senate special election last Tuesday has sent shock waves through Washington. Suddenly, every statement Brown made in the campaign is being viewed by some as the final word on national issues ranging from climate control to foreign policy. But before we decide to let one man’s views determine the fate of some of the most important polices in our nation’s history, we need to examine each issue and the context in which it was raised. Take national health care reform for example.

Brown campaigned against the pending national health reform bills, but isn’t against health reform altogether. In fact, he voted for Massachusetts’s own health care reform as a state legislator-a remarkably successful program that has reduced the rate of people without insurance in Massachusetts to five percent, by far the lowest in the nation (New Jersey’s rate is about 15 percent, close to the national average). Ironically, the national health reform bills were largely based on the Massachusetts model.

The great danger now is that in response to this election, health reform will be scaled back or abandoned altogether. Since it has been decided that health reform will not proceed until Brown is seated in the Senate, the Democrats no longer have the votes to pass a final compromise bill with the House. Procedurally the easiest way to avoid that impasse is for the House to pass the Senate bill with no changes then send it to the President for signature-by-passing the Senate altogether. But there appears to be no support in the House to do this.

Brown believes that everyone should have insurance; but that states should achieve that goal on their own. That’s easy enough for Massachusetts to say. The rate of uninsured people in that state was already one of the lowest in the nation even before the reforms. It has never had the same challenges in this respect that New Jersey and other states currently have.

Recently, the President has indicated that he might support a new bill if it has bipartisan support. But the Democrats and Republicans do not agree on much. At this point the only major consensus is on market reforms that have no federal cost, like prohibiting insurers from denying coverage for pre-existing conditions.

The nation’s heath care system can only be improved in a comprehensive, systematic way-piecemeal solutions won’t work. If market reforms are enacted, individuals must be required to buy health insurance in order to spread the risk between sick and healthy, young and old-much like any other insurance. But if individuals are required to have insurance, we must also provide subsidies for those people who cannot afford the premiums. This, of course, should be funded at the federal level because the states do not have the necessary resources.

The point of reform is to address all of these interrelated issues-to get at the root causes of our broken health care system that threaten our nation’s health and economy. The election in Massachusetts shouldn’t change this.

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Filed under health care reform, Monday Minute, New Jersey Policy Perspective

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