Magazine article The American Prospect

Bipartisanship in One Party

Magazine article The American Prospect

Bipartisanship in One Party

Article excerpt

As the debate over health reform enters its decisive stage, there is a lot of talk about the need for compromise between Democrats and Republicans. That was a sensible point to make in years past when Republicans offered alternatives for reform to compete with Democratic proposals. But this year there are two problems with the idea of bipartisan compromise. The first is that Republicans in Congress have not even made a pretense of offering constructive alternatives. The second is that the Democratic proposals are built around the ideas that Republicans used to favor--those proposals already are bipartisan compromises. Unfortunately, they are compromises with a Republican Party that no longer exists.

In the late 1940s, when Harry Truman proposed legislation for national health insurance (what today would be called a single-payer plan), a group of Republicans including Congressmen Richard Nixon and Jacob Javits advocated a system of government-subsidized, private nonprofit insurance, with premiums scaled to people's incomes.

In the 1960s, when Democrats were calling for a program of government hospital insurance for the elderly, Republicans countered with a plan for voluntary insurance for physicians' bills. The Democratic proposal became Part A of Medicare; the Republican proposal became Medicare Part B (which is government-run but voluntary).

In 1974, as president, Nixon sent to Congress legislation for universal coverage that relied on private insurance to cover the employed and a federal program to cover the rest of the population. National health insurance, Nixon declared, was "an idea whose time has come in America," but because of Watergate his own time had gone. If he had only been wounded instead of destroyed by scandal that year, he might well have struck a deal with Sen. Ted Kennedy, by that time the leading Democratic advocate of national health insurance.

As recently as the early 1990s, when Bill Clinton and other Democrats were again pushing for universal coverage, President George H.W. Bush and such leading Republicans as Sens. Bob Dole and John Chafee countered with their own proposals for reform. Their bills would have expanded coverage by subsidizing private insurance, and Chafee's plan called for an individual mandate--a requirement that individuals carry health coverage.

Republicans offered these proposals, to be sure, only when Democrats were pressing for reform, and the plans were often merely for show. …

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