Yesterday, during an appearance on CSPAN’s Newsmakers, Rep. James Clyburn (D-SC) suggested that an incremental approach to covering the uninsured would be better “than to go out and just bite something you can’t chew“:
I don’t know exactly what the President’s plans are with moving for universal coverage, But I know this — If you take what we’ve done with SCHIP and you follow that with community health centers, you will have gone a long way toward building a foundation on which to build a universal access health care program. I would much rather see it done that way, incrementally, than to go out and just bite off something that we can’t chew. We’ve been down that road. I still remember in 1994.
Clyburn is correct to highlight the political challenges of passing comprehensive health care reform. As Bob Laszewski has often pointed out, the only way Obama can accomplish health care reform “is if he and his administration spend the time to bring the American people up to speed on just what those sacrifices look like” to “force the stakeholders out of their ‘me’ mode and ready to accept the ‘difficult choices and issues of sacrifice and responsibility an duty.”‘
Despite its challenges, however, the heavy lifting of health care reform is politically rewarding. Since we can’t fix the economy without addressing skyrocketing health care costs or lower rising costs without bringing everyone into the system, a broad approach to health care reform is the only politically viable option.
To lower the health care costs of his constituents, Clyburn would have to bring everyone into the system. “In 2002, uninsured South Carolinians cost the system $1,936 per uninsured individual” and without extending coverage to the 16 percent of South Carolinians lacking health insurance or reversing South Carolina’s dubious and costly distinction of falling into the top ten unhealthiest states for eleven years in a row, Clyburn is wasting his voters’ money.
Pushing for big health reform is politically rewarding precisely because it will ultimately save the government and American taxpayers money and help restore the economy. In fact, rather than serving as a deterrent to comprehensive reform — as Clyburn suggests — the consequences of failing to achieve reform in 1994 are a stark warning against incrementalism, or worse, inaction.
Clyburn certainly understands and appreciates the facts, statistics, and economic arguments — he just doesn’t think that it’s politically feasible. But given the intimate connection between the economy and health care costs and general popularity of taking a “bite” out of the health care crisis, comprehensive reform seems not only politically possible, but absolutely essential.