SCOTUS on Thursday; on Friday we still need a deal

The Supreme Court has set Thursday, June 28, 2012 as the last day of its term, and their ruling on the Affordable Care Act should be released shortly after 10am that day. Tyler Cowen has a useful note of caution to those who think they want the law struck down:

If the Supreme Court strikes down ACA in part or as a whole, and you did not like the law in the first place, do not assume you should be happy. It is far from obvious that we will end up with something better. I do hope that today (or later this week) is not simply a big exchange of anger and recrimination. No matter what happens, America still needs health care reform and this will require cooperation across the ideological spectrum.

The heart of my book Balancing the Budget is a Progressive Priority is that we need a long range sustainable budget, and that a necessary, but not a sufficient condition to getting one is a deal on health reform that identifies some steps we are willing to actually take. We have got to shift health reform away from being a political football, and into something that both political parties bear responsibility for seeing through. This piece provides what I claim to be what the beginnings of what a health reform deal would look like if the two “sides” actually negotiated based on their policy interests (more , more, more). My book nests health reform as central to the drive for a long range sustainable budget because health care costs are the primary cost side problem long term.

And it will take a tax increase over historical levels in the long run given any plausible level of spending if we are to ever have anything near a balanced budget again. And keep in mind, for all the discussion of the Ryan health reform plans, the primary House committees (Ways and Means and Commerce) where the heavy health policy lifting will have to be done have taken no steps beyond being clear about what they are against in the 17 months that Republicans have controlled that chamber. What that means on the meta level is that the Republican party:

  • claims to have a long range balanced budget as a key policy goal
  • Is opposed to one of the things it will take to get one (a tax increase) and has no plausible plan for the other (health reform)

In other words, they have no chance of achieving their stated goal, especially when you factor in their preferences for Military spending.

As I have said over and over, the Republicans desperately need a health reform deal, and seem to be the last to know. Think of how much political capital the Democratic party invested in passing the ACA, and then consider the likelihood that Republicans would ever invest this much in any health reform effort. Not going to happen. More important than the politics, the entire country needs for the two parties to reach some sort of a deal, so that we can address the human suffering caused by lack of health insurance, while beginning to take steps to address health care cost inflation that is unsustainable as the baby boomers move into Medicare and Medicaid.

Thursday will come, but so will Friday.

About Don Taylor
Professor of Public Policy (with appointments in Business, Nursing, Community and Family Medicine, and the Duke Clinical Research Institute), and Chair of the Academic Council at Duke University . I am one of the founding faculty of the Margolis Center for Health Policy. My research focuses on improving care for persons who are dying, and I am co-PI of a CMMI award in Community Based Palliative Care. I teach both undergrads and grad students at Duke. On twitter @donaldhtaylorjr

2 Responses to SCOTUS on Thursday; on Friday we still need a deal

  1. Pingback: A simple deal « freeforall

  2. Pingback: Quick thought on negotiations « freeforall

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