Is Switzerland a Model of Health Care Compromise?

Berne Tram

Ezra Klein writes that Republicans are drawing the lines of opposition to the progressive health care agenda in pretty narrow terms:

Does that matter? It’s hard to say. Rhetorically, the GOP has staked out a very narrow corner of opposition. Last week, Mitch McConnell, Chuck Grassley, Mike Enzi, Orrin Hatch, and Judd Gregg — essentially, all the Senate Republicans with jurisdiction over health reform, and McConnell — co-signed a letter to President Obama. I’ve obtained a copy, and it’s up for download here. They draw two lines in the sand. First, they warn against using the budget reconciliation process to pass heath care. Doing so would “make it difficult to gain broad bipartisan support” and “do a disservice to this important issue.” Substantively, they fear a public insurance option. “Forcing free market plans to compete with these government-run programs would create an unlevel playing field and inevitably doom true competition,” they say. “Ultimately, we would be left with a single government-run plan controlling the market.”

When I was in Switzerland, I learned a bit about their health care system. In essence, it looked like the plan Democrats were talking about on the campaign trail but without the public option. And that, it seems to me, would be compatible with what the Republicans are saying here. And just in time, Regina Herzlinger from the Manhattan Institute chimes in at the Corner in praise of Switzerland:

Republicans, full of complaints about the Obama plan, have not coalesced around a viable alternative. Mired in fantasies about a replay of 1992, they think they can face down universal coverage and that their impossibly wonky ideas, full of tax takeaways and mysterious high-risk pools, will defeat Obama’s brilliantly clear proposals. […] There is only one viable Republican solution: A consumer-driven system that passes the employer tax exemption and funding onto consumers, so they, and not the government, control all health-care costs. Switzerland, which enables universal coverage without any governmental insurance through this system, benefits from costs 40 percent lower than the U.S. and, unlike the single-payer systems in the U.K. or Canada, excellent results for the sick.

Obama has formally committed himself to the idea of a Medicare-like public option, but the availability of such an option is not one of the administration’s eight principles for health reform. This suggests the possibility of a compromise if the GOP wants it. My strong guess is that if leading Republicans were really willing to offer a Swiss-style system as a compromise measure, that Democrats would leap at the chance to take a clean legislative victory and start haggling over funding mechanisms rather than fight to the death over a public plan.

At the same time, for that very reason until such an offer is made I think it’s vital to fight like crazy for a public plan since it’s the risk that such a plan would be rammed through the Senate via budget reconciliation that gives conservatives their incentive to come to the table and strike a deal over something more modest.