Gingrich, Daschle Offer Bipartisan Healthcare Improvements

Without a doubt, the inability of the Democrats and Republicans to work together has the electorate in a snit. That the electorate is responsible for the heels being dug in is beside the point. A way to break this logjam comes from a rather unlikely pairing over an unlikely source of harmony. Former Speaker Newt Gingrich (R-GA) and former Senate Majority Leader Tom Daschle (D-SD) concerning the Affordable Care Act. It could serve as a model for future cooperation.

In a report from the Bipartisan Policy Center, the two have suggested reforms to the ACA as permitted under Section 1332 of the legislation. The two wrote in this morning’s Washington Post:

Section 1332 of the Affordable Care Act creates a process for generating State Innovation Waivers — the result of a bipartisan agreement between Sen. Ron Wyden (D-Ore.) and then-Sen. Bob Bennett (R-Utah). As a result, both sides have the ability to explore ways to serve taxpayers and patients better by rewarding innovative, localized and effective systems of care delivery while maintaining critical protections.

Beginning in 2017, the provision allows states to opt out of the Affordable Care Act requirements, so long as certain conditions or “guardrails” are adhered to. These guardrails require states to offer coverage that is at least as comprehensive as the ACA’s essential health benefits package; that is at least as affordable; that insures at least a comparable number of residents; and that maintains federal deficit neutrality.

Earlier in their article, they state, “This doesn’t mean that conservatives and Republicans have to give up the fight to reduce the regulations and taxes in the law. It also doesn’t mean that progressives and Democrats have to stop defending protections for the underinsured and uninsured.”

This is important because it returns to possibility of compromise to the political system without requiring a compromise on principles, only on strategy and tactics. Federal systems are particularly well-suited to experimentation at the local and state (provincial) level. Those that succeed can be scaled to the nation as a whole, while those that do not adversely affect far fewer than would otherwise be the case. In additon, failed approaches can be replaced by those that have succeeded elsewhere with relative ease.

One sees the seeds of a new paradigm for US domestic policy here. Allow the federal government to enshire in law the objectives, establish a basic framework both legally and bureaucratically to achieve those objectives, and once the system is up and running, let the states experiment on making it work better. National goals and standards refined by state and local reforms might just be the formula America needs to get things done again.

Howver, there is one implicit assumption in the Gingrinch-Daschle report that may yet prevent the country from moving ahead. In their report and in their Post article, there is a belief that the other side is not evil, out to destroy the nation or undermine the Republic. Instead, each side recognizes the concerns of the other, and each accepts that the other side has a legitimacy in its concerns. It starts from the belief that more and better healthcare is a national objective with which no one sane would resist. In other words, everyone is trying to get to the same place, and the disagreements are over direction and speed.

In essence, politics is not a matter of carving up a pie. It is a case of each side bringing its pieces of the puzzle to the table and of putting them all together as a country.