Why bipartisanship is essential if we're to fix American health care

Health care is at the top of everyone’s list of what is important in the coming election. Democratic contenders continue to promote Medicare for all, for some or none. Republicans have sued to kill Obamacare. 

But close your eyes and think about what you want for your own health care.

One, you want health insurance.

Two, you want health care to be affordable. That means that with all the other expenses you must pay such as rent, food and clothing, you can still afford to see a doctor and get prescription medicines.

Three, you want it to be “adequate," which means you and your family remain healthy and the health care you receive keeps you that way as much as possible.

Would our goals for the country be any different than our personal goals?  No.

Most Americans want everyone to have health insurance. A Texas Medical Center Health Policy Institute survey found that  more than 90% of people said they wanted to have health insurance.  But more than 27 million people don’t have health insurance. 

A lot of work has been done on what seems to be affordable for families. For those with extremely low incomes, perhaps 2 percent of income is affordable; for those who make more, perhaps up to 8 percent. Yet, about 30 percent of those who have insurance pay more than that, which means they can’t afford it.

Affordability is a shared goal

We also need health care to be affordable for the country as a whole. We spend twice as much for health care as the average developed country.

Finally, the country needs adequate health care. How do we define that?  The two best measures are life expectancy (we are 43rd in the world) and infant mortality (we are 55th in the world).

So we all agree, right?  We have the same goals, and we recognize that we are not close to achieving those goals.

Where reasonable people differ is on how to attack the problems we have. Republicans favor a market-based approach; having the individual consumer take charge; and having more competition among insurers, including selling insurance across state lines.  Democrats, as we have heard during the presidential debates, would expand the role of government.

Use states to test plans

Some may say that these solutions can never live together. But what if Republicans worked on a plan for families making more than 400 percent of the federal poverty level, and Democrats put together a plan for those with low incomes. Then we would lock the two sides in a virtual room to come up with a single plan with input and discussion from a wide range of professionals and members of the public.

The plans that emerge could then be negotiated.  Perhaps different states might try one or the other.  The Health Partnership Act several years ago proposed federal grants for states that tried new ways of addressing our health care issues. Perhaps it is time to try state-based federalism again.

Talking it out: Learning to discuss complicated issues ahead of the election

We want to hear from you: Be a part of the solution to finding solutions. Tell us here.

In the long run, it will be essential to have bipartisan support for any major legislation.  If we can start from first principles and agree that we really do want the same things, we can work toward consensus. Yes, that is Pollyannaish now. But after the election, no matter who wins, it will be vital.

Arthur Garson, Jr. is the author of "Exposing the 20 Medical Myths: Why Everything You Know About Health Care is Wrong and How to Fix It." He was dean of the University of Virginia School of Medicine, and provost of the university. He is a past president of the American College of Cardiology.