Health Care Reform Without the Shouting

Last Updated Sep 9, 2009 3:12 PM EDT

Most Americans agree on the broad outlines of health care reform. No one, Republican or Democrat, believes that the current health care system give great value for the money. No one, Republican or Democrat, believes that it's a great idea for health care to be tied to employment. No one, Republican or Democrat, thinks it's a great idea for those with pre-existing conditions to be denied insurance and left to go bankrupt .

Going into his fateful speech tonight, the President has more common ground with reform opponents than you'd think. I was struck by this list in economist Ed Yardeni's email blog. Yardeni, by the way, is a harsh critic of the Obama Administration, but even he could find eight basic points of agreement with reform crusaders. Yardeni writes:

Given all the shouting, it is hard to imagine that the opposing sides agree on anything. We should try to concur on some basic principles and work from there toward a compromise that might benefit all of us. Let me suggest a few relatively noncontroversial talking points that might be a good place to start:

(1) The health care system may work for many of us, but too many Americans aren't receiving sufficient care.
(2) Even if the system is working well for most of us now, it will be strained to accommodate the needs of retiring Baby Boomers.
(3) While health care isn't an entitlement, all citizens should have access to good care. It should be universal.
(4) Health insurance should be transportable. It should not be employer based.
(5) There should be a way to cover pre-existing conditions.
(6) Senior citizens should have adequate access to health care regardless of their age.
(7) Health care should be financed on a pay-as-you-go basis rather than through government deficits.
(8) Finally, I think that we can all agree that we can't all have access to unlimited free care. There must be some limits imposed either by the government or by the marketplace.

Most of the heat after the speech tonight will be about the public option and the risk that a government-run insurance plan will drive out private insurers-or conversely, that without competition from the public sector, private insurers will have no incentive to price insurance fairly. But there are compromise ways to create competition, either by deregulating insurance and letting health insurers compete across state lines or by the Senate's health-care non-profit cooperatives.

Somehow or other, a compromise will be struck. On the basic goals and the need to fix health care's problems, we're closer on the goals than we were on tax reform and the Social Security rescue in the 1980s. We're going to have to deal with this issue sometime. It ought to be now.

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