The Founding Fathers purposely made it difficult for Congress to enact sweeping legislation. Our Constitution’s separation of powers demands coordination and consensus to pass especially meaningful and impactful laws. For that reason, most of the significant pieces of legislation passed in the last 60 years, after lengthy and sometimes colorful debates, ultimately achieved bipartisan majorities on final passage.
For instance, 153 Democrats and 136 Republicans in the House voted for the Civil Rights Act of 1964, arguably the most meaningful piece of legislation enacted in the 20th century. Medicare, another transformative piece of legislation, passed the House with 237 Democrats and 70 Republicans in support. The Tax Reform Act of 1986, one of the most ambitious pieces of tax legislation passed in decades, passed the House with 176 Democrats and 116 Republicans in favor.
Yet, comprehensive healthcare reform proposals have stubbornly bucked this bipartisan tradition. The pattern emerged when Hillary ClintonHillary Rodham ClintonObama to net 0K for Wall Street speech: report O’Reilly: Fans will be ‘shaken’ when truth comes out about Fox exit Overnight Cybersecurity: White House adviser ditches cyber panel over ‘fake news’ | Trump cyber order ‘close’ | GOP senator pushes for clean renewal of foreign intel law MORE worked on healthcare reform 25 years ago and reached its zenith when Congress passed the Affordable Care Act with only Democratic votes. Before the April recess, the Republican Party continued in this dubious tradition by trying to amass only Republican votes for the American Health Care Act, and it came up a few votes short.
The truth is that we still need a major reboot on healthcare. Both parties understand that the Affordable Care Act has weaknesses that restrict choice and inflate prices in the individual market. These challenges need to be addressed sooner rather than later or real people will be hurt. Rather than start with one party crafting a solution and trying to attract a few moderates from the other party, now is the time to restart the process by gathering well-intentioned people from across the entire ideological spectrum around one table.
Fortunately, the Bipartisan Policy Center has convened a representative group of health policy experts to meet for three to four months with instructions to hammer out a consensus proposal to improve our healthcare system. This is a positive and welcome development. The group includes respected representatives from numerous ideological camps. At the table are conservatives who believe that consumer-driven healthcare that includes less regulation, more individual responsibility and increased use of health savings accounts is a significant part of the answer and progressives who favor expanded federal programs, increased resources for those who need them and further regulation of insurers and exchanges. The group also includes thoughtful experts who fall between these ideological poles, all of whom want to spend their valuable time crafting a consensus proposal.
Two important ground rules should be set for the group and for meaningful work on these issues by anyone going forward. First, the mission for this work should decidedly not be characterized as “repeal and replace ObamaCare.” In fact, the group should avoid the use of labels like “ObamaCare,” “TrumpCare” and “repeal and replace.” These phrases have become partisan weapons that serve to divide rather than unite. Instead, the mission should be what we all want — responsible suggestions to improve our health system. This effort and others like it should work to reach agreement on practicable and achievable improvements to how we as a society fund and provide healthcare.
Second, the group should agree to work to craft proposals to achieve the following goals that members of both parties can support:
• Improve and strengthen the individual insurance market so there is a lively and competitive marketplace;
• Expand the availability of affordable insurance coverage aimed at reducing, rather than increasing, the current numbers of uninsured people;
• Strengthen the safety net for those who need it while not creating incentives for others to rely on it unnecessarily;
• Accelerate the transformation of the health system from one that rewards volume to one that rewards value, which is necessary for reducing our system’s unsustainable costs; and
• Address the non-healthcare impediments to achieving improved health by breaking down silos between healthcare and non-healthcare spending and rewarding increased personal responsibility for activities that maintain and improve health.
Guided by the staff of the Bipartisan Policy Center, this group should work together earnestly, craft a practical proposal and deliver it to the leadership in Congress. Then, the committees of jurisdiction would hopefully hold hearings on the proposal with the express desire to develop bills that have broad bipartisan support.
It’s noteworthy that President Trump and his top aides have expressed an openness to work across the aisle on healthcare. The Bipartisan Policy Center has a vitally important role to put in motion the process to deliver a concrete plan to Congress and ultimately to the president that he can support and sign.
Healthcare reform proponents must learn an important lesson from our nation’s past debates over civil rights, Medicare and tax reform: Coming together and working across the aisle is key to enacting legislation to bring about fundamental change.
Tersigni is president and CEO of St. Louis-based Ascension, the nation’s largest nonprofit health system. Follow Ascension on Twitter at @ascensionorg.
The views expressed by this author are their own and are not the views of The Hill.
It’s time to come together to improve our healthcare system