‘Reform’ can’t blossom behind closed doors

‘Reform’ can’t blossom behind closed doors

Who could have guessed that when Brian P. Lamb, CEO of C-Span, asked Democratic leaders in the House and Senate to open conference committee meetings on the health-care reform bill to the electronic media that the answer would be neither yes nor no? Instead, the answer from House Speaker Nancy Pelosi, Senate Majority Leader Harry Reid and President Barack Obama was, to paraphrase a line from The Treasure of the Sierra Madre, “Conference committee meetings? We don’t need no stinkin’ conference committee.”

But that, unfortunately, is what is happening.

Rather than pursue a conventional legislative process (and one that has often been open to the print and electronic media) when the House and Senate have approved separate versions of legislation, Democratic congressional leaders and the White House have decided to take a different, more private route.

Too big to ignore

This would be bad under the best of circumstances. Given that the legislation involved is health-care reform — an issue that will touch every American and involves about a sixth of the U.S. economy — it is terrible.

We understand the frustration of the Democrats and the White House. Republicans long ago made it clear that the party had no desire to pass health-care reform. Some of them believed reform wasn’t necessary. Some acknowledged a problem, but believed they had better reform ideas. And some clearly adopted a partisan strategy articulated in July by Sen. Jim DeMint of South Carolina that if the Republicans could defeat Obama on this signature issue it would be his “Waterloo.” The party that preached for eight years that “elections matter” was willing to pursue an agenda that would assure that this president’s election mattered not.

But none of that excuses the Democrats’ decision to pursue reconciliation by surprise.

There are important differences between the Patient Protection and Affordable Care Act passed by the Senate Dec. 24 and the Affordable Health Care for America Act passed by the House Nov. 7.

Pages of different pages

Focus on Health Reform funded by the Kaiser Family Foundation put together a side-by-side synopsis of some of the major differences, and that took 24 pages.

The bills have different approaches — some minor and some substantial — in such areas as coverage requirements, the impact on Medicaid and Medicare, subsidies, tax changes and credits, public option proposals, state involvement and how the costs of all the changes will be covered.

Those are the kind of issues that should be worked out in an open forum, in a conference committee made up of Democrats and Republicans. The American people should be trusted to interpret how members of both parties behave in working toward a compromise. Most Americans recognize that the continually rising cost of heath care, which is doubling every eight or nine years, is unsustainable. And most know that it will take more than cosmetic changes to reverse the trend.

History tells us that if this health-care reform effort collapses, there won’t be another attempt for years. If the past is any guide, by the time Congress would next recognize a need to act, costs will have doubled again and health care won’t represent a sixth of the economy, it will be a fifth. How many companies can budget $25,000 per employee for annual health insurance premiums? How many families can set aside a dollar out of every five for health care?

Reform is needed, but Pelosi, Reid and Obama have to find a better way of closing the deal. And that means providing the process with something that always enhances democracy: sunshine.

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