Bill Frist on Health Bill: I’d Vote For It

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Or so the former Senate Republican Leader, a surgeon who has written a new book on health care, told me a few minutes ago in an interview.

Were he still in the Senate, “I would end up voting for it,” he said. “As leader, I would take heat for it. … That’s what leadership is all about.”

This is not to say that Frist is entirely happy with everything that is in the bill.

For one thing, he doesn’t think it does nearly enough to bring costs under control. In his view, it does not fundamentally change the incentives that providers now have to provide more care, rather than better care. “There is really nothing to bend the cost curve,” he says.

And Frist also predicts it will extend coverage to only 20 million or so additional Americans–far short of true universal coverage. Given the fiscal constraints, he says a better approach would be to provide a more bare-bones package of benefits, known as “catastrophic coverage.” That less expensive insurance, while not covering as many routine medical services, would be affordable to more people and provide for care should they suffer a serious illness or condition that might otherwise bankrupt them.

However, he strongly supports other aspects of the bill–most notably, its requirement that individuals be required to purchase coverage, if they do not receive health insurance through their employers or under government programs. And he also lauds the provisions that would eliminate practices that allow insurance companies to discriminate against people based on their health history, including pre-existing conditions.

Frist also faults some in his own party for injecting alarmism into the debate. “Clearly, the death panels and public plan arguments have been overblown,” he says. Frist noted that Republicans themselves voted for a Medicare prescription drug bill that would have established a version of a public plan–with the government negotiating directly with drug companies–if private-sector competition had failed to materialize. That is similar to the approach that Republican Senator Olympia Snowe is taking with her amendment to establish a public option with a “trigger.”

While Frist believes that the bill will pass, he worries that the Obama Administration and Congress have not given enough attention to what happens next: the implementation. The first few years are likely to be rough, he predicts. States will be struggling to set up new marketplaces for insurance coverage, their medicaid rolls will grow, taxes will go up, and consumers will not yet see the benefits. “The Republicans will go wild,” using the start-up difficulties as a tool for fundraising and for making their case in the next election, Frist says. “In the Congress, nobody’s thinking about that.” His advice for the Obama Administration: “Stay nimble,” and be prepared to make adjustments as difficulties arise.

UPDATE: Our friend Jon Cohn has an interesting observation:

For those keeping a tally, that’s three former Republican Senate Majority Leaders who have endorsed the sorts of reforms President Obama and his allies are pushing. Previously, Howard Baker and Bob Dole signed on to a plan they negotiated with Tom Daschle and George Mitchell, former Democratic counterparts, through the auspices of the Bipartisan Policy Center.

And this is as it should be. For all of the crazy talk about a radical government takeover, health care reform 2009 is an amalgam of compromises, many based on ideas taken straight from former Republican proposals–the kind of proposal, in other words, at least a few Republicans should be able to embrace in good faith.

Now if only some currently serving members of the party could take a cue from the retired elder statesmen…