I always liked Bill Bradley when he was a Senator, but as a bipartisan dealmaker, he leaves something to be desired:
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.
There’s a huge problem with this deal: the Republicans won’t take it because they aren’t really serious about malpractice reform.
The Republicans had undivided control of the national government for four years. They did enact class-action litigation “reform,” which took many class actions out of state courts and into federal courts (they only believe in federalism when it’s about civil rights, of course). This was a direct payoff to the tobacco, chemical, insurance, and other industries that had backed Republicans over the years. But during that time, they did nothing about malpractice.
Malpractice lawsuits essentially serve as a figleaf for Republicans when they are asked about health care costs, which they basically do not want to do anything about. Conservatives see health care as a commodity, no different from widgets. If you don’t have money for health care, you die: end of problem. But they can’t say that, so they scream about plaintiffs’ lawyers, even though tort lawsuits comprise a minuscule amount of health care costs (Bradley does not say where he gets his 10% figure from, which is good for him, because it is nonsense).
Put another way, Republicans can’t “fix” the malpractice “problem” because if they did, they wouldn’t have it to kick around any more.
Barack Obama found this out in the spring. According to Time’s Karen Tumulty,
When Barack Obama informed congressional Republicans last month that he would support a controversial parliamentary move to protect health-care reform from a filibuster in the Senate, they were furious. That meant the bill could pass with a simple majority of 51 votes, eliminating the need for any GOP support for the bill. Where, they demanded, was the bipartisanship the President had promised? So, right there in the Cabinet Room, the President put a proposal on the table, according to two people who were present. Obama said he was willing to curb malpractice awards, a move long sought by the Republicans and certain to bring strong opposition from the trial lawyers who fund the Democratic Party.
What, he wanted to know, did the Republicans have to offer in return?
Nothing, it turned out. Republicans were unprepared to make any concessions, if they had any to make.
Does Bradley know this? Maybe. My first thought was that he had just gotten suckered by GOP rhetoric, but maybe Dollar Bill is calling their bluff.
In any event, the path to health care reform is clear to all: reconciliation.