Starting Over On Health Care
Obama Has to Write His Own Bill

By Bob Dole
Monday, August 31, 2009

Health-care reform is the No. 1 domestic priority. With all the charges and countercharges, those who will be affected, the American people, are understandably confused. Many are angry. Reform of our health-care system is a gigantic undertaking, but too many measures have been drafted in congressional committees by liberal Democrats. It's become too much for many to grasp.

After 35 years in Congress, I know there are times when a fresh start is advisable.

If I were a White House adviser, I would suggest that the day Congress reconvenes, President Obama's version of reform should be introduced by Democratic leaders in the House and Senate. Health-care reform is the vital issue of our time, and Obama should be out front with his specific plan on this make-or-break issue.

Many of us were taught that the president proposes and Congress disposes. Today, Congress is doing both -- with the president relegated to the role of cheerleader in chief as he campaigns for various House committees' efforts. Certainly, Obama supports much in these proposals -- but Barack Obama is our president, not a commentator.

Obama's approval numbers would jump 10 points if Americans knew he was fully in charge. A tactical move of introducing his own plan would also stir more Republicans to become active for reform in critical areas. Right now the president's biggest problem is with congressional Democrats, who are split and searching for a way out of the medical wilderness.

In short, the president, Congress and the public are choking on all this, and choking is not covered by the legislation.

When I served as Senate Republican leader, I recall President Ronald Reagan telling me after he'd sent a bill that I would introduce that he wanted it all -- but that if I could get 70 to 80 percent, to run with it, and he would try to get the rest later. Neither Reagan nor Obama has been considered a master of Congress, but both are known for their great popularity and for understanding the art of reaching for more than they could reasonably expect. Now, consider this: Members of Congress want to keep their jobs. They support their president, but they also want to be employed, with a good health plan (like the one they enjoy now), after this president or even the next has come and gone. So votes on this issue are not simply partisan. They are also about survival. Most lawmakers, Republican or Democratic, will think long and hard before casting this vote -- to avoid backing into a buzz saw.

Once the president has staked out his position, which will provide room for amendments, the debate will narrow, and bipartisan bargaining and other political maneuvering can begin.

The goal is getting legislation without driving certain private sectors, such as the health-insurance industry, out of business. Issues such as administrative costs and coverage for those with preexisting conditions can be resolved without any "public option" or the "co-op" provision under discussion. All of these can be postponed for five years or more. If the industry has not shown marked improvement by then, reforms could be imposed because most of the proposed legislation, if passed, would not be implemented for three to four years in any case. I believe the industry is responsible and would clean up its act, as needed, as soon as possible.

Along with former senators Howard Baker and Tom Daschle, I serve on the advisory board of the Bipartisan Policy Center, a group searching for common ground on health care, energy, agriculture, transportation and national security. After more than a year of work on health care, we made our recommendations public in June. We were assisted by many experts, including Chris Jennings, President Bill Clinton's top health adviser, and Mark McClellan, who headed the Centers for Medicare and Medicaid Services and the Food and Drug Administration under President George W. Bush.

Out of Congress now, we have no votes and no power -- but we have our credibility. It is pleasing that many lawmakers, particularly the Senate Finance Committee leaders, Democrat Max Baucus and the GOP's Chuck Grassley, have looked favorably upon some of our recommendations.

Having watched Congress tackle health reform before, I think it best to avoid the "reconciliation" process, by which part of a plan could be written into legislation that requires 51 votes, and not 60, on its way to passage. This president may be up to his ears in Democratic votes, but I suspect that many will not vote for a bill put forth through reconciliation.

Republicans have different ideas but for the most part are positive about reform if the government has a minimal role. Democrats would eventually regret it if Republicans are forced to take a nearly party-line vote. Obama should get the credit if legislation passes but, more important, get the blame if final legislation draws only a few GOP votes and brings more taxes, more government and more spending .

A bipartisan ending will have more credibility with the American people. Indeed, most important legislation in U.S. history has had broad bipartisan support. As a supporter of bipartisan health reform, I hope the president has gotten some rest in the past week. I also hope he puts the final touches on his own health bill. I'd bet a bottle of aspirin that it would cure many of his headaches.

The writer is a retired Republican senator from Kansas and former majority leader.

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