75% Want Health Care Law Changed - Rasmussen Reports™

The word from Rasmussen Reports is that the health care law as written is popular with only 18% of survey respondents.

The latest Rasmussen Reports national telephone survey finds that 75% of Likely U.S. Voters want to change the law, while only 18% want it left alone. Those figures include 20% who want the law repealed and nothing done to replace it, 28% who want it repealed and then have its most popular provisions put into a new law and 27% who say leave the law in place but get rid of the unpopular provisions.

It is worth noting that a majority (55%) take one of the middle ground approaches—repeal and replace or leave it and improve.

What concerns me is the fractured nature of the 75% who want it changed – how do we reach agreement on what needs to be changed, how to change it, and what to do first?  While others have written about this already, I have a few ideas of my own….

I think there are several ‘clusters’ of repeal/replace options which should be debated independently of each other.  This would allow creation of alliances of support for changes in one area that may not area on changes in another area.  Separate bills for each change would enable legislators with different political philosophies to work together as needed to make the most change possible.

Here are some of the clusters I can envision:

• Dropping elements of the current bill which are bad ideas in hind sight.  This one should be an easy winner, since even Obama agrees that some requirements in the original legislation (like the small business 1099 reporting requirement) were bad ideas.
• Eliminating much of the bureaucracy that current bills calls for.  Everything from IRS reviews to HHS tribunals, there is too much in the law which is intrusive, unjustified and disruptive of the doctor-patient relationship.  Not only that, the requirements for things like electronic record keeping and direct payments from checking accounts are unreasonable given that the government is unable to keep military or State Department secrets, and has utterly failed in restraining identity theft and use of forged Social Security numbers.
• Adding things that Democrats generally don’t like.  This would be difficult given the current make-up of the power arrangement in Washington (more on that later), but it should be part of the discussion.  The two key elements here are tort reform and buying insurance across state lines, but the discussion should include other “competition” topics such as publishing prices for medical procedures, publishing data on hospital and doctor results for common procedures, etc.
• Encourage intelligent planning and competition in the healthcare industry.  In the past, the government has operated as an obstacle to competition, and this is one of the best examples:  In the 1970s, as hospitals were looking at costly expansion to cover cardiac care, burn units, trauma units and more, the four major hospitals in Phoenix decided that rather than each adding all of these services, they would specialize and refer patients to the hospital capable of offering advanced services as needed.  The Justice Department stepped in and threatened to sue them for restraint of trade, price fixing, etc. unless they dropped those plans and each developed all of the services.  The result is that there is no way each hospital can cover the costs of all of these services, resulting in higher costs for all patients in order to make up the difference.  Intelligent planning would allow for regional hospitals to specialize as long as the population base would have access to all required services.

I’m sure there are other clusters, these are just a few to start the dialog.  As the Rasmussen Reports survey indicates, those under 30 want to leave the bill in place and modify it, while those over 50 want to repeal the bill and start from scratch.  We need to find a middle path, and I’m hoping this post assists in clarifying what that path might look like.