Healthcare reform is going to require bipartisan effort

Welcome to one of the smallest clubs in Washington: those of us still hoping for bipartisan deal making that produces broadly acceptable national policy. We urge you to add health reform to your portfolio because history teaches us major social policy change seldom succeeds without the backing of both parties.

The Affordable Care Act, passed strictly along party lines in 2010, is a case in point. For any replacement of the ACA to gain traction, and become the effective salve to health system woes that Americans deserve, a bipartisan effort must ensue.

{mosads}Any doubts? Look at the track record of Social Security, the Civil Rights Act, and Medicare, just to name a few. All were exceedingly complex issues, fraught with financial and emotional costs. And all were enacted with bipartisan support.

Consider as well the advice that two respected former political leaders—Vice President Walter Mondale, a Democrat, and Senate Majority Leader Howard Baker, a Republican— mentioned several times to members of the Mayo Clinic board of trustees. Without bipartisan support, they said, “The outside party will use it as a political football.”

The ACA was enacted when Democrats controlled the White House, the Senate, and the House of Representatives. Mondale and Baker’s warning played out shortly after the 2010 mid-term elections, when the Democrats suffered massive defeats in national and state elections and lost the majority in the House.

With both parties in play, the new health law got shuttled to the Supreme Court, which unsettled the health care system, weakened the law and ultimately put consumers at risk.

We urge Republicans to not make the same mistake the Democrats made when considering repairs to the ACA. Politics is mercurial. But one thing is certain: neither party will control three branches of government forever. And the citizens of our country need and deserve a better functioning, affordable health system that is sustainable for future generations.

There are many good examples of bipartisan action to draw from:

The Medicare vote during President Lyndon Johnson’s presidency in 1965 was especially insightful. The Democrats controlled 68 Senate seats (60 votes are required to overcome a filibuster). But the vote to approve Medicare came from 57 Democrats and 13 Republicans. LBJ knew that getting the bill passed was only the first step. He used his political savvy and arm-twisting skills, not to muscle his own party, but to ensure that both parties would push out this major legislative vehicle to the American people and, in current parlance, “own it.”

President Reagan and Democratic House Leader Tip O’Neill came up with an effective bipartisan way to reform Social Security in 1983. The popular program for seniors, survivors and the disabled faced a funding shortfall. To ensure solvency, the two leaders developed a compromise that would, only slightly, raise taxes and curtail benefits. The House vote on this reform is testament to its bipartisanship: Republicans voted 80 yea and 86 nay; Democrats voted 163 yea and 105 nay.

We need a bipartisan reform of the Affordable Care Act that can transform a political football into a major solution. A caucus of problem-solving lawmakers seems like the perfect place to start.

Health reform is a critical policy issue impacting the lives—and pocketbooks—of every American. The average citizen does not view health care from a political party perspective. We need to approach change to the U.S. health care system from the perspective of the average citizen. Uppermost  in our minds should be to ensure that health care is affordable and patient-centered. We must eliminate waste from the system and provide better results and lower spending (value) across the board.

We were heartened by the words of Rep. Tom Price at his first Senate confirmation hearing to become Secretary of Health and Human Services: “The last thing we want to do is go from a Democrat health system to a Republican health system. Our goal would be to go to … an American health care system that recognizes the needs of all.”

We can begin with the items we all agree upon: expanding health insurance to millions more Americans, including individuals with pre-existing conditions and young adults signing up via their parents’ policies. We also agree that the ACA fell short in important respects—high costs, a confusing array of new regulations and an insufficient emphasis on quality.

Now is the time for leadership and compromise. It took leadership for LBJ to shoulder through a change as massive and costly as Medicare. It took compromise, and mutual respect, for Reagan and O’Neill to solve a Social Security fiscal crisis.

Major social policy that benefits millions of people, for many generations, is something that can take years to get right. The Affordable Care Act has shown us a lot in six years. Now we need to take those lessons and move forward in a bipartisan way. Sure it’s hard. But that’s why we have political leaders.

Ceci Connolly is [resident and CEO of the Alliance of Community Health Plans and a former national health correspondent for the Washington Post. She is an author of the book “Landmark: The Inside Story of America’s New Healthcare Law.” Dr. Denis Cortese is director of the Healthcare Delivery and Policy Program, Arizona State University and Emeritus CEO of Mayo Clinic. Robert Smoldt is associate director of the Healthcare Delivery and Policy Program, Arizona State University and Emeritus CAO, Mayo Clinic.​

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