The Founding Fathers purposely made it difficult for elected officials to enact sweeping legislation. Our Constitution's separation of powers demands coordination and consensus to pass especially meaningful and impactful laws. For that reason, most of the significant pieces of legislation passed in the last 60 years, after lengthy debate, ultimately achieved bipartisan majorities on final passage.
For example, 153 Democrats and 136 Republicans in the House voted for the Civil Rights Act of 1964. In Wisconsin, legislators have a strong history of working together to pass bipartisan health care legislation. For example, legislators have come together to address the heroin and opioid epidemic in Wisconsin through the HOPE Agenda. Wisconsin's elected leaders have also come together to support hospitals and health care providers by investing in Medicaid and workforce development programs. Yet, comprehensive health care reform proposals have stubbornly resisted this bipartisan tradition nationally.
The truth is we still need a major reboot on health care across the country and in central and northern Wisconsin, Ministry Health Care, part of Ascension, the nation's largest non-profit health system - is privileged to serve. Both parties understand that the Affordable Care Act has weaknesses which restrict choice and inflate prices in the individual market. These challenges need to be addressed sooner rather than later because real people will be affected. Rather than start with one party crafting a solution and trying to attract a few moderates from the other party, now is the time to restart the process by gathering well-intentioned people from across the entire ideological spectrum around one table.
On a national level, the Bipartisan Policy Center has convened a representative group of health policy experts to meet with instructions to develop consensus proposals to improve our health care system. The group includes respected representatives from numerous ideological camps. At the table are conservatives who believe consumer-driven health care that includes less regulation, more individual responsibility and increased use of health savings accounts is a significant part of the answer and progressives who favor expanded federal programs, increased resources for those who need them and further regulation of insurers and exchanges. The group also includes thoughtful experts who fall between these ideological poles, all of whom want to spend their valuable time crafting a consensus proposal. This is a positive and welcome development.
Important ground rules should be set for the group and for meaningful work on these issues by anyone going forward. First, the intent of this work should not be characterized as "repeal and replace ObamaCare." In fact, the group should avoid the use of labels like "ObamaCare," "TrumpCare" and "repeal and replace." These phrases have become partisan weapons that serve to divide rather than unite. Instead, the goal should be what all of Wisconsin wants - responsible suggestions to improve our health system. This effort and others like it should work to reach agreement on practicable and achievable improvements to how we as a society fund and provide value-based health care at an affordable cost.
Second, the group should agree to work to craft proposals to achieve the following goals that members of both parties can support:
Improve and strengthen the individual insurance market so there is a lively and competitive marketplace;
Expand the availability of affordable insurance coverage aimed at reducing, rather than increasing, the current number; of uninsured people;
Strengthen the safety net for those who need it while not creating incentives for others to rely on it unnecessarily;
Accelerate the transformation of the health system from one that rewards volume to one that rewards value, which is necessary for reducing our system's unsustainable costs; and
Address the non-health care impediments to achieving improved health by breaking down silos between health care and non-health care spending and rewarding increased personal responsibility for activities that maintain and improve health.
Guided by the staff of the Bipartisan Policy Center, this group should collaborate to craft practical proposals and deliver it to Congressional leadership, so that Congress can work together to come to agreements on proposals that can move forward.
It's noteworthy that the new administration has expressed an openness to work across the aisle on health care. The Bipartisan Policy Center has a vitally important role to put in motion the process to deliver concrete plans to Congress and ultimately to the president.
Health care reform proponents in Wisconsin and nationally must learn an important lesson from our nation's past debates over crucial issues including civil rights, Medicare and tax reform: Coming together and working across the aisle is key to enacting legislation to bring about fundamental change that would ultimately benefit those we serve in central and northern Wisconsin.