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The Coming Test for Health Care Reform

Robert Pear’s story in today’s New York Times on Democratic health care plans exposes the beating heart of the congressional debate over President Obama’s reform proposals. Overall, the administration’s campaign to overhaul the health care system is going well, Pear reports, with the White House “displayinga surprisingly light touch,” as it herds disparate constituencies toward consensus. The rub for Republicans is Obama’s insistence on a public insurance option to compete with private plans.

The key point in Pear’s reporting:

Lobbyists and Congressional aides have discussed a possible compromise: Congress would authorize a new government-run insurance program, but it would come into existence only if certain conditions were met — if, for example, private insurers failed to rein in health costs by a certain amount after several years.

This is the negotiating point to watch. As managed care consultant Joesph Paduda points out, fears that a public plan will crowd out, and eventually eliminate, private insurance are overblown. If the Democrats buy into this insurance industry compromise, the drive for fundamental reform will falter.

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