LOPEZ: Are Republicans credible on the issue? Is anyone?
MILLER: If we grade them on a very generous political curve (compared to who else?), they are credible in terms of what they do not like and what they oppose. Like the broader public, there’s not much credibility or consistency in what they propose to do about serious and persistent health-care policy problems. There is plenty of blame to go around, and not just in the political realm. Hence, the only consensus position widely held among almost all actors in this tragi-comedy is, “It’s someone else’s fault!” One credible starting point involves recognizing that the most essential solutions will have to come outside of politics, legislation, and regulation. But reducing the heaping pile of public-policy debris that clouds this issue and stands in the way of private parties and civil society taking more responsibility for fixing this mess would constitute a necessary, if not sufficient, first step.
LOPEZ: What are the best states for health-care reform?
MOFFIT: Utah stands out in pursuing a pilot program to create personal, portable, private health insurance for small businesses and their employees in its market-based health-insurance exchange. Consumer choice and competition are the key features of the reform, and there is virtually no bureaucracy. Starting as a pilot program in 2009 with eleven employer groups, it has grown to 68 in 2011, and there are 88 more waiting to enroll in the next two months. Indiana has been successful in controlling costs through a popular expansion of health savings accounts. And Texas has enacted medical-malpractice reform that has dramatically improved the climate for medical practice. States should move ahead as quickly as possible on their own reforms, and change the facts on the ground. They should not wait for Washington to tell them what to do, and they should tell Washington what they are going to do. Inaction is tantamount to surrender.
LOPEZ: Who in Congress should people follow?
CAPRETTA: House Budget Committee chairman Paul Ryan fully understands the importance of getting American health-care policy right. He introduced a market-based alternative to Obamacare in the last Congress, and he understands that existing federal health-entitlement programs are a big part of the cost problem. So he definitely has the right vision for where we need to go. There are many other terrific leaders on health care in Congress, especially the physicians. Congressman Mike Burgess has really taken on all aspects of this issue at the Energy and Commerce Committee, and Sen. Tom Coburn is a strong advocate for moving power and control from the government to citizens
LOPEZ: Republicans seem to be poised to take on entitlements. Is that ignoring the will of the people, like Obama and the Dems did with health care? Or is that an absolutely wrong analogy?
CAPRETTA: We are at a pivotal moment in our history. If Obamacare goes into effect in 2014, it will be very difficult to unwind, as millions of people will get signed up for new entitlement benefits. Moreover, there is no getting around the fact that avoiding a debt-induced economic crisis is going to require entitlement reform. Those who want to avoid a massive increase have no choice but to begin the conversation about an alternative vision to the president’s high-tax, high-spend approach. Moreover, the president himself appointed a bipartisan task force last year to address these very issues, and Senator Durbin and others have endorsed cuts to Social Security as part of that process. Entitlement reform will never be easy. But there is no more time left for delay.