While elected Republicans are busy polishing their Luntz-inspired, poll-tested talking points about a government takeover of the health care system and complaining about a ‘lack of bipartisanship,’ a bipartisan group of former Senate Majority Leaders — Howard Baker (R-TN), Tom Daschle (D-SD), Bob Dole (R-KS) and George Mitchell (D-ME) — have released a comprehensive health care proposal that incorporates many of the President’s principles. Jonathan Cohn has the details:

There is a requirement that businesses pay towards the cost of insurance for their employees, along with a requirement that everybody get insurance. To make coverage affordable and available to individuals and small businesses that can’t get coverage now, the bipartisan group would set up an insurance exchange; there, insurers couldn’t deny people coverage or charge them more just because they have pre-existing conditions. People buying insurance through the exchange would also be eligible for subsidies, depending on their income levels.

To pay for the plan, the bipartisan group would draw on a combination of new revenues and savings from the health systems–again, not radically different from the ideas now under consideration in Congress. They’d try to squeeze $500 billion out of Medicare and Medicaid, another $500 billion from new revenues including a cap on the exclusion for employer tax benefits, plus $200 billion in some other efficiency changes. That would make the measure revenue neutral, since projections (from MIT economist Jonathan Gruber) show the new outlays would add up to $1.2 trillion over ten years.

This may be the first comprehensive, bipartisan proposal that seeks to truly bridge the gap between the ideologies. As such, it has a little something for everyone. Progressives may be disappointed with the proposal’s reliance on federal standards as a minimum for benefits (although that’s just a minimum and states may go beyond if they chose), limiting the tax exclusion for employer-provided coverage (although retirees and collective bargaining agreements are exempt) and a state-based trigger that would allow the federal government to provide financial and technical assistance to states that want to establish alternatives to private insurance.

But this is what compromise looks like. In turn, Republicans Dole and Baker embraced Medicaid expansion, an employer mandate, an individual mandate, an independent health care council that would “make recommendations to improve quality of care and avoid unnecessary costs in federal health programs,” comparative effectiveness research “relevant to patient decisions and effective health care policy reforms,” funding for quality measures, and reimbursement reforms to reward quality and care coordination. These are no small concessions and they would have been unimaginable just 16 years ago.

The truth is, this fully financed proposal includes 70-80 percent of the President’s principles. It builds on the employer-based system and really goes a long way towards ensuring that all Americans have access to affordable and adequate coverage. But the politics are also important. Baker, Daschle, Dole and Mitchell know the Senate and the mechanics of achieving bipartisan compromise. Their endorsement is not only refreshing (given the current state of debate) but it’s also politically encouraging.

Today, as the HELP Committee began marking up the ‘Affordable Health Care Act,’ Republicans tried to obstruct the effort by complaining that the Congressional Budget Office (CBO) had not yet scored the entire proposal.

But as Sam Stein reported yesterday, it was Republicans who pushed for the incomplete HELP bill to be studied by the CBO, and “when poor results came back,” they pretended that the agency scored the entire bill. Indeed, yesterday, Reps. John Boehner (R-OH), Eric Cantor (R-VA), Sens. Mike Enzi (R-WY) and John McCain (R-AZ) criticized the committee for producing a bill that cost $1 trillion but covered only 16 million Americans, purposely ignoring the CBO’s admission that “those figures are not likely to represent the impact that more comprehensive proposals…would have both on the federal budget and on the extent of insurance coverage.”

But today, Sens. McCain and Judd Gregg (R-NH) argued that the hearing be postponed until a full cost-analysis is available. Watch it:

The delaying tactics extended into the GOP’s amendments. Rather than offering constructive improvements that could lower costs and expand coverage, a good number of the GOP’s proposed amendments do nothing to solve the health care crisis:

- Coburn 51: To prohibit the use of funds to build football stadiums.

- Coburn 111: To prohibit the Department of Health and Human Services from providing funding for fashion shows.

- Enzi 59: To prohibit the Secretary from requiring the use of best practices.

- Enzi 87: To strike provisions relating to oral health.

- Coburn 43: To rename the community health program subtitle IV – would rename it the “Federal Takeover of Local Communities.”

- Coburn 102: To limit the amount the Department of Health and Human Services may spend on conferences each year

- Coburn 29: To ensure that abortion providers are not co‐locating at schools in order to be integrated into school‐based health clinics and gain access to potential clients.

Ezra Klein observes that “the Republicans on HELP feel, or say they feel, that they were frozen out of this process. They say the bill is inadequate and its path to creation has been unforgivably partisan.” But these Republican fail to advance reform or solve the health care crisis. Rather, they preserve the current system, which, as Sen. Barbara Mikulsky (D-MD) observed during the hearing, “is a combination of Adam Smith, Darth Vader, and Invasion of the Body Snatchers.”

The Republicans are introducing yet another alternative to the Democrats’ health care plan. This leadership-backed proposal — developed by Rep. Roy Blunt’s (R-MO) ‘working solutions’ health care group — rhetorically compliments earlier alternatives but offers little in the way of solutions. The Republicans have issued a set of talking points, not a comprehensive reform proposal.

Rather than focusing on reducing the growth of health care costs and extending coverage to every single American, for instance, Republicans are proposing implementing comprehensive “medical liability reform” — the total cost of malpractice constitutes just 0.46 percent of total health care expenditures — eliminating “waste fraud and abuse,” providing “new refundable and advanceable tax credits,” and improving health savings accounts.

The focus is messaging, not policy. During multiple appearances on MSNBC for instance, Rep. Dave Camp (R-MI) framed the Republican alternative as “an American plan,” implying that the Democrats are proposing an anti-American plan or perhaps an Italian health care reform plan. Pressed for details of the Republican proposal, Camp could only offer “we are going to try to incentivize people to go into the health insurance market and get coverage.”

Also on MSNBC, Rep. Eric Cantor (R-VA) attempted to co-opt the President’s language by insisting that the Republican alternative would provide Americans with greater choice. Pressed by the Nation’s Katrina vanden Heuvel on how he can oppose giving Americans the choice of a government health care plan while receiving health care from the government, Cantor demurred.

Watch a compilation:

On the whole, the plan does very little to cover the uninsured, protect individuals from predatory insurance practices or extend coverage to more Americans. The draft “encourages states to use new and existing programs to guarantee all Americans, regardless of pre-exising conditions or past illnesses, have access to affordable coverage” and helps Americans eligible for employer-based plans to enroll in coverage.

Given the dearth of ideas, it’s no surprise that “the public doesn’t exactly have a tremendous amount of confidence in Republican leaders on the issue.” According to a new Gallup poll, only “34% are confident that GOP leaders Congress will make the right decisions about health care reform — less than the insurance companies (35%) or the pharmaceutical companies (40%).”

On Monday, Sens. Jon Kyl (R-AZ), Mitch McConnell (R-KY), and Pat Roberts (R-KS) introduced the “Preserving Access to Targeted, Individualized, and Effective New Treatments and Services (PATIENTS) Act of 2009,” a new bill prohibiting Medicare or Medicaid from using “comparative effectiveness research to deny coverage.”

For Kyl, fear mongering about the consequences of government-takeover of health care or medical research is a part time job. He actively rallied against medical research during the stimulus debate, Kathleen Sebelius’ confirmation, and today, he took to the Senate floor to attack Democrats of seeking to “ration care”:

Watch it:

Pharmaceutical representatives currently instructs doctors on the effectiveness of medications, and the industry opposes research that would lead the government to eschew coverage for ineffective or unnecessary treatments. Fewer prescriptions translate into lower profits and the industry lobbied hard to pare down the cost effectiveness language in the House and Senate versions of the stimulus bill. In fact, the pharmaceutical and biotechnology industries have donated $1,971,968 to Kyl’s career election efforts and ran ads on Kyl’s behalf in 2006. Moreover, according to recently released 2008 personal finance disclosures, Kyl invests heavily in pharmaceutical companies.

His latest effort prohibits the government from using “data obtained from the conduct of comparative effectiveness research…to deny coverage of an item or service under a Federal health care system.” The language compliments the GOP’s larger argument that Obama’s health care reform would usher in the era of European-style socialized-medicine and rationed care, but it ignores the government’s existing ability to make coverage decisions.

As Thomas Scully, the Administrator of the Centers for Medicare and Medicaid Services (CMS) from 2001-2003 pointed out in an interview with ThinkProgress, “you know, Medicare makes decisions on coverage all the time. I made decisions on coverage all the time….You got to do it the right way. But I think – I’ve always been a big fan of comparative effectiveness research if done correctly.”

In reaching coverage decisions the Center for Medicare and Medicaid Services relies on an evidence-based process, conducts internal research and consults outside assessments. Upon CMS’s request, fifteen experts on the the Medicare Evidence Development and Coverage Advisory Committee review, evaluate, and collect medical literature and technological assessments and examine the data based on effectiveness and appropriateness. Only then, does the panel of experts issue a coverage decision.

It’s unclear why Kyl and his conservative colleagues would deny Americans the fruits of scientific research. The Food and Drug Administration oversees the safety of food, drugs, and cosmetics and bans the use of harmful products. If the government can ban harmful lipstick, why can’t it deny coverage for a dangerous drug or medical devise and protect access for patients who need experimental treatments? As Peter Orszag pointed out during recent Congressional testimony:

There also are a lot of less extreme ways of guiding medical practice. For example, simply paying more for the things that work than the things that don’t….And so it doesn’t need to be a simple on-off switch.

After all, “there is no reason we cannot set up reasonable procedures, overseen by independent health professionals, to protect patients who can demonstrate a special need for a treatment that is not normally cost-effective.”