By Morton M. Kondracke Roll Call
In the spirit of bipartisanship supposedly inspiring Thursdays Blair House health care summit I thought Id seek advice from a knowledgeable group unfortunately not represented the nations governors.
So I interviewed two of them Democrat Phil Bredesen of Tennessee and Republican Mitch Daniels of Indiana.
Coming from completely different views about the ideal health care system they agreed on this: Instead of trying for comprehensive overhaul this year Congress and the administration should go incremental."
(Along the way after urging him to run for president in 2012 as a conservative who gets things done" I got Daniels to allow that theres a 2 percent chance" that he might.)
Both Bredesen and Daniels have standing on health care. Both have fostered overhaul in their states and invented programs that work.
Bredesen told me that despite their experience managing Medicaid the governors have been shunted aside" in the federal overhaul process.
He said he was one of four governors deputized by the
National Governors Association to talk with the White House congressional leaders and staff but I had the feeling we were a base to be touched not that they were listening."
Governors will not be included at the televised bipartisan summit that took place across the street from the White House.
Congress and President Obamas real mistake" Bredesen said was that they went way too far toward what some activists think is ideal with a comprehensive set of benefits that is way too expensive."
He said that current Democratic plans remind him of the TennCare program he inherited in 2003 which was driving his state into bankruptcy and he revamped by cutting benefits and enrollment.
Instead he said You could move forward the president could get a victory and Republicans could be seen as cooperating on a more limited benefit for a population that everyone agrees is deserving."
He means offering a basic health insurance package to 20 million workers whose employers do not cover them.
If employers had to contribute 25 percent of the cost the worker 25 percent and the government 50 percent the cost would be $430 billion over 10 years less than half of Obamas latest proposal.
Bredesen instituted a similar plan in Tennessee called CoverTN but has funds to offer insurance to only 23000 of the states 400000 uninsured workers.
If Bredesen had his way the nation eventually would have a universal coverage system like France or Germany where all citizens are covered in a single non-means-tested system. But he said the United States cant afford that now.
Daniels as befits a conservative Republican starts with the opposite view. He favors eliminating employer-based insurance and giving tax breaks to individuals to buy their own policies.
Which translates into consumer-driven health care. Im a believer in the idea that until every one is a cost-controller there wont be cost control" he said.
In the present debate though he said Id at least hope that both sides could agree on some incremental changes including portability of policies buying policies across state lines and medical malpractice reform."
In Indiana Daniels has been experimenting with variations on health savings accounts (HSAs) much favored by the GOP but hated by Democrats to supplement Medicaid.
The Healthy Indiana Plan offers the uninsured a high-deductible ($1100) insurance policy that covers up to $300000 in annual medical expenses and up to $1 million over a lifetime.
Participants pay part of the $1100 into POWER accounts an acronym for Personal Wellness and Responsibility with the state contributing the rest. Money saved can be carried over to the next year.
To answer the Democratic objection that people with HSAs avoid preventive care such services are free in the Indiana plan and 81 percent use them.
The plan covers only 50000 of 350000 potential clients because its paid for strictly by an increase in tobacco taxes. Daniels does not want to create an entitlement that will blow a hole in his states budget like the one he inherited and painstakingly closed.
Daniels also has offered the HSAs to state employees and an astounding 70 percent are using them. They are saving fortunes and we are saving tens of
millions" he said.
Daniels believes that limited government does not imply inactive or inert government." To solve the nations most dangerous problems especially the national debt Id be willing to accept the second- or third-best answer as opposed to doing nothing while we go over Niagara Falls."
He also believes in having grown-up adult conversations" with Democrats and wants the GOP to present a constructive and inclusive program to the country" enabling it to govern not just win the next election."
I dont plan to run for president in 2012" Daniels said at a Feb. 23 press breakfast. I dont expect to do it. I dont really want to do it."
But he told me Its about a 2 percent chance I could run." I hope he does.
