3 ideas that beat single-payer to reform health care

No issue is more important to the American people — or more turbulent — than what to do about health care in our nation. As the national discussion on health care continues, very publicly and at all levels of government and within the populace, we need focus on what is realistic and what will work.

Most progressives, and a large percentage of would-be presidential candidates on the Democratic side, have pledged to try to adopt a single-payer option. Single-payer has failed in experiments, such as those attempted in Vermont and Colorado, and at the moment it’s not where progressives should focus their resources. Trying to adopt such a system right now would cost an incredible amount of money and, therefore, would lead to a dramatic increase in taxes for the average American. That’s just not politically feasible in the current environment.

{mosads}By some estimates, a national single-payer system could cost $32 trillion over a decade and require an average annual tax increase of $24,000 per household. And while, in the long run, such a significant tax increase may not be needed — a recent report touted by progressives found that single-payer would reduce other costs — the truth probably lies somewhere in between. It’s really an academic discussion.

Single-payer is not a realistic option because there is no time in the foreseeable future when it will be politically viable. Even if the Democratic Party were to take back the House and Senate in 2018, and the White House in 2020, that would not be enough to pass single-payer into law. As was demonstrated by President Obama’s failed attempted to put a “public option” in the Affordable Care Act (ACA), it is unlikely we could even hold 100 percent of Democrats to vote for single-payer.

Even though the party controlled the White House, Senate and House, the public option was voted down. And even if somehow every Democrat supported single-payer, we could not get the 60 votes needed to stop a filibuster in the Senate. On the Republican side of the aisle, I can see one or two potential votes for single-payer, at best.

So how can we resolve the health care crisis and improve the quality and accessibility of care now? We can do this in three fairly direct ways.

First, by passing into law a new type of public option that allows people between the ages of 55 and 65 to buy into Medicare. This is the age bracket that often has the most trouble finding coverage, and taking their demographic out of the larger coverage pool would substantially reduce the cost that health care plans would have to charge everyone else.

Second is an idea advanced by John Kerry in his 2004 presidential campaign — that the federal government adopt a stop-loss plan that would mean it would share the cost of a patient’s medical bills in excess of $100,000 a year. This would have a cost attached to it, especially since we might need to raise the amount above $100,000 because of inflation, but would result in significant savings. And taking these high-cost patients out of the pool would allow others to have significantly reduced premiums for health care coverage.

Third, Congress should study ways the federal government can help drive down the prices of pharmaceuticals for Medicare and Medicaid, to help reduce overall costs for both programs. This would dramatically reduce the cost of both government programs and would not be a totally unique approach, since the Department of Veterans Affairs already has that right.

These three direct changes are not simple, but not overly complex. They are substantively and politically achievable. If we were to adopt them, we would make America’s health care system infinitely more accessible and affordable.

Edward G. Rendell was the 45th governor of Pennsylvania. He is a former mayor of Philadelphia and former district attorney in that city. He served as chairman of the Democratic National Committee during the 2000 presidential election. He is now co-chairman of the Immigration Task Force at the Bipartisan Policy Center.