With all this presidential politics going on, it’s hard to keep up with some of the subtler and wonkier public policy developments. The always-excellent Matt Miller has a fascinating column in the Wapo today on the proposed health care compromise backed by Oregon Senator Ron Wyden and Congressman Paul Ryan. This could be a big deal.
I’ve been a Ron Wyden fan for a long time. His proposed health care plan, which would have moved us past our clunky and decrepit employer-based system, was more radical than Obamacare, but would have liberated U.S. businesses from the burden of providing health care for their employees while providing a universal progressive voucher system. When it became clear that his plan was a non-starter (despite having 19 co-sponsors, equally divided between the parties), Wyden proposed a clever tweak to Obamacare–he would have allowed companies with fewer than 100 employees to opt into the health care exchanges (essentially, health-care super-stores that have to take any and all customers) that are at the heart of any serious health care reform.
Paul Ryan has now accepted that model, which is excellent. In return, Wyden has accepted a less-harsh version of Ryan’s Medicare plan (which set up the equivalent of health care exchanges for senior citizens)–which, among other things, would include a public option.
This is excellent, creative progress. It’s only a beginning. It doesn’t fully address the cost containment issue at the heart of Medicare. It doesn’t fully address the excesses of fee-for-service medicine. But it does recognize that you can’t simply repeal ObamaCare–that the health care system has to be reformed if we’re going to get a deficit problems under control. It also is clear evidence that there are compromises to be had, if politicians eschew cheap politics and begin thinking about the greater good.