PERSPECTIVE FROM THE 19^TH HOLE: This is the title I chose for my personal blog, which is meant to give me an outlet for one of my favorite crafts – writing – plus use an image from my favorite sport, golf. Out of college, my first job was as a reporter for the Daily Astorian in Astoria, Oregon, and I went on from there to practice writing in all of my professional positions, including as a Congressional press secretary in Washington, D.C., an Oregon state government manager in Salem and Portland, press secretary for Oregon’s last Republican governor (Vic Atiyeh), and a private sector lobbyist. This blog also allows me to link another favorite pastime – politics and the art of developing public policy – to what I write.

There is an old phrase that suggests “it is not a good idea to beat a dead horse.” Don’t know the derivation of that strange phrase, but is could apply to my perspective on health care.

I lobbied health care issues at the Capitol in Salem for all of my 25 years in the private sector business. In Salem, at least part of the time, those involved in health care policy – either the legislators themselves or the lobbyists representing health care interests – found a way to meet in the middle…not the exact middle, of course, but not on either extreme either.

One of the reasons for this, at least when it came to funding health care, dealt with this requirement: Before legislators can leave Salem after a six-month session, they have no choice but to balance the state budget.

On occasion, I and other lobbyists were concerned that health care was the
“balancer” – that is, legislators made other major “general fund” spending decisions first (K-12 education, higher education, corrections, police) before getting around to health care.

I could prove that, but no matter for now. The point was that legislators had to produce a two-year balanced budget, THEN head home.

That, obviously, is not the case in Washington, D.C.

There is nothing that compels a balanced budget on health care or any other subject so Members of Congress and the president rarely ply that ground.  And, beyond the budget, they develop extreme positions, then hold to those positions at all costs while, at the same time, chastising the other side (or sides) as being out of touch and stupid.

Witness the current debate in Congress on health care.

President Donald Trump went on the offensive in an opinion piece published by USA Today last week. Perhaps to no one’s surprise, he used the piece as an opportunity to lambast Democrats rather than to argue for Republican health care policy proposals. Specifically, he went after the Democrat proposal to establish a national single-payer health care system. He accused the left of wanting to spread radical socialism by gutting Medicare, which, also, is not true.

Trump also said he had defended protections for people with pre-existing conditions. Not true. No matter what Trump says, his Justice Department has said it will no longer support provisions in the Affordable Care Act that protect people with pre-existing conditions – and that has been a potent campaign issue for Ds running this November.

So, in the normal spirit of health care issues, the president has nothing with any potential to work.

What about the Democrats?

Well, they have little to add that has a chance of enticing the middle. Senate Minority Leader Chuck Schumer declared last week that “health care is the issue that will define the November elections.”

He could be right for the wrong reason. Democrats could end up paying a big political price for signing up en masse for Senator Bernie Sanders’s government-run health-care agenda, which can be called a “single-payer system” or even, now, BernieCare.

Senator Sanders’ bill known as Medicare for All, which has been endorsed by 16 Senators, including almost all of the left’s leading 2020 presidential contenders – Senators Cory Booker, Kamala Harris, Kirsten Gillibrand and Elizabeth Warren).

A companion House bill has attracted more than 120 co-sponsors, which is nearly two-thirds of the current Democratic caucus.

Medicare for All would finance health care through taxes instead of insurance premiums, deductibles and co-pays. All care would then be “free,” at least in theory. Government would dramatically cut the reimbursement rates doctors receive for providing services. All this would lower administrative costs and make health care more efficient, or so we’re told. And we’re not supposed to call this “government-run health care,” though who do you think would make the payment decisions?

Trump noted in his op-ed that the plan would cost the federal government $32.6 trillion over 10 years. That figure is from an analysis by the Mercatus Center’s Charles Blahous, a respected researcher whose findings are in the ballpark of every serious analysis.

That spending figure amounts to 10.7 per cent of GDP in 2022 when the plan kicks in and then up from there. National defense—routinely derided as too expensive and wasteful—is a mere 3 per cent of GDP today. And brace yourself: “Doubling all currently projected federal individual and corporate income tax collections would be insufficient to finance the added federal costs of the plan,” Blahous says.

And that’s the good news. The truth is that BernieCare would essentially blow up the entire current health system. The Sanders bill would eliminate employer-sponsored insurance, which now covers some 150 million Americans. The sales pitch for that should be: If you like your health-care plan, we won’t let you keep it.

BernieCare would also blow up Medicare as we know it by creating a new health system that young and old would have to join.

So on it goes. Neither the Republicans nor the Democrats have any health care proposals with any potential to appeal to the middle. Republicans just want to shoot the Affordable Health Care Act, which is really not affordable at all. Democrats want a single payer system that would drive the federal budget ever deeper in debt.

America can do better than this. But we need political leaders who will move toward the middle and, as voters, we need to support that kind of enlightened leadership.