Washington Matters


More Health Care Consensus Than You Think


There's no underestimating the challenge President Obama faces in trying to get Congress to pass the kind of health care overhaul he wants, but the task is far from impossible. For one thing, Democrats are loath to face the voters next year with nothing to show on health care. More important, perhaps, is the fact there is more agreement on key elements than most people realize. After a meeting at the White House Tuesday, Senate Majority Leader Harry Reid of Nevada said there is agreement on 90% of what's being discussed.

Of course, the remaining 10% is the most difficult, but the past month of raucous debate should not be allowed to drown out the consensus that exists on the rest:

--- There is wide agreement, for example, on insurance market reforms that would require insurers to offer coverage to everyone, regardless of pre-existing conditions, at a reasonable price.

--- Most lawmakers think market reforms must include a requirement that individuals buy health insurance. That's necessary to broaden the risk pool so insurers can cover more people and bring down premium costs.

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--- Insurance "exchanges" of some type are likely to help buyers find and compare competing health care plans.

--- There's general agreement on the need for subsidies for those who can't afford to buy coverage on their own, although the size of the subsidy, how to provide it and the level of income needed to qualify are matters of debate.

--- Tax incentives to help small businesses that want to provide health care have widespread support among members of both parties.

--- And more emphasis on wellness and prevention care, as well as payments to providers based on the success of a treatment, rather than on the number of tests or office visits.

Of course, that leaves a lot of room for disagreement on the details, as well as on how to pay for the cost of extending care to some or most of the 45 million people who don't have insurance now. Also to be decided: Whether of not to add a public option of some kind to compete with private insurers. Obama and most Democrats favor one as a way to pressure private insurers to keep rates down, but most Republicans say it is the first step toward a government takeover of health care.

 




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