Still looking for a better way

Walden echoes health reform criticisms but offers no comprehensive alternative

Rep. Greg Walden was more than happy to sympathize with members of The Chamber of Medford/Jackson County last week over their dislike of the national health care reform law, but his expressions of outrage at the botched rollout of the new system lacked something important: a better solution.

It's true that the rollout of the website that was supposed to let consumers shop for coverage quickly and easily has been a colossal failure, and the Obama administration has been forced to delay implementing key provisions of the new law as a result. On Thursday, the White House announced people whose individual policies have been canceled will be allowed to buy catastrophic coverage policies and won't be penalized if they don't buy insurance next year.

That's frustrating, but it's important to remember some key points:

  • The website is not the health care system. It's merely a portal connecting people with the system, and it can be fixed.
  • The policies that were canceled were canceled because they did not comply with the minimum standards for coverage set out in the new law. In other words, they weren't very good policies.
  • Any reform plan that seeks to overhaul the entire health care insurance system while preserving a competitive private insurance marketplace, as this one does, is bound to be fiendishly complicated and plagued with problems at first.
  • The Affordable Care Act was passed because the health care system in this country was broken. Repealing it would only restore a dysfunctional system.

Walden echoed the often-heard criticisms of the reforms: The national website is very costly, and the reforms are too sweeping.

He suggested the same alternative approaches Republicans have offered from the beginning: Instead of a sweeping overhaul, enact a few less drastic changes. Let different employers pool together to get better rates. Let insurance companies compete across state lines to bring down costs. Limit damages in malpractice suits to reduce costs.

Those sound very reasonable, except that they either already are part of the Affordable Care Act or they wouldn't have much impact on costs.

Different groups of employers pooling together? That's what the insurance exchanges are designed to do under the new law.

Competition across state lines? The ACA lets states allow that, but only if they band together in compacts to enforce basic standards for coverage. Otherwise, insurance companies could engage in a "race to the bottom," offering substandard polices at cut-rate prices to entice customers without improving their coverage.

The tort reform suggestion sounds good, but wouldn't have much effect. A Harvard University study found medical liability costs, including "defensive medicine" practiced by doctors, account for just 2.4 percent of the total cost of health care.

Walden was careful to note that he supports covering Americans regardless of pre-existing conditions — a popular element of the health care law — but didn't say how he would compensate insurers for requiring them to cover everyone. The ACA does that by requiring everyone in the country to have insurance, driving the cost down for all.

It's easy to criticize an effort to change something as complex as the health care system if you don't have to offer a better idea.

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