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August 31, 2009

Bradley's Health Care "Grand Bargain" Unlikely

Marc Comtois

August has been a tough month for Team Obamacare Force and prospects look pretty grim for their version of "comprehensive" amorphous health care reform. But as current Democrat politicians are being put on notice that they are in trouble come 2010, the old Warhorses are coming out to buck up the whippersnappers and remind them that they had better keep on keepin' on and pass health care reform. One of them is former Sen. Bill Bradley. In a Saturday New York Times (h/t) piece, Bradley recalled that President Reagan's tax reform plan of 1986 required real bi-partisanship, including the willingness of both sides to give up on some closely-held policy positions.

None of this would have happened had the Reagan administration not taken on some of the Republican Party’s sacred cows — the oil and gas industry, real-estate interests and large industrial enterprises, all of which benefited disproportionately from loopholes. Similarly, the bill would never have passed had some Democrats not taken on an ingrained party orthodoxy — the belief that equity demanded higher tax rates.
According to Bradley, a compromise bill could achieve two long term goals held by each party:
Since the days of Harry Truman, Democrats have wanted universal health coverage, believing that if other industrialized countries can achieve it, surely the United States can. For Democrats, universal coverage speaks to America’s sense of decency and compassion. Democrats also believe that it will lead to a healthier and more productive country.

Since the days of Ronald Reagan, Republicans have wanted legal reform, believing that our economic competitiveness is being shackled by the billions we spend annually on tort costs; an estimated 10 cents of every health care dollar paid by individuals and companies goes for litigation and defensive medicine. For Republicans, tort reform and its health care analogue, malpractice reform, speak to the goal of stronger economic growth and lower costs.

The bipartisan trade-off in a viable health care bill is obvious: Combine universal coverage with malpractice tort reform in health care.

I agree with Steven Hayward: "I give it less than one chance in ten of happening." Why? As the Washington Examiner editorializes:
Howard Dean proved last week at Rep. Jim Moran’s health care town hall meeting that even a veteran Washington politician can level with people once in a while. The former Vermont governor and Democratic presidential aspirant was a practicing physician before he got into politics, so perhaps we should not be surprised by his explanation for why medical malpractice caps [i.e. tort reform] is not in Obamacare: “The reason tort reform is not in the bill is because the people who wrote it did not want to take on the trial lawyers in addition to everybody else they were taking on. And that’s the plain and simple truth.” Put otherwise, trial lawyers have effectively bought themselves veto power.

In the ranking by OpenSecrets.org of campaign contributions by the top 100 special interests during the past 20 years, the American Association for Justice (AAJ) – formerly the Association of Trial Lawyers of America – ranks sixth overall. The AAJ is the trial lawyers’ Washington lobbying group, and 90 percent of its $30.7 million in contributions since 1989 went to Democrats. At the other end of this pay-to-play process in the nation’s capitol, AAJ has spent nearly $14 million lobbying Congress just since Democrats won control of both chambers, including $2.3 million thus far this year.

Maybe Hayward's estimate of the chances of a Bradley-like compromise should be revised further downward.