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On bipartisan health care, a foundation for agreement

By Kathleen Sebelius and Nancy-Ann DeParle
Thursday, February 25, 2010; A23

Over the past year, we've had a vigorous national conversation about how to bring down health-care costs for families, hold insurance companies accountable, make health-care affordable for those who don't have it and lower the deficit. Today, Democrats and Republicans have a chance to come together, share their best ideas and unite behind reforms that will put families and small-business owners back in control of their health care.

Since this debate began, media coverage has focused almost entirely on areas of disagreement between the two parties. But as two people who have spent much of the past year discussing health reform with President Obama and other Democrats, Republicans and independents, including many of the Republicans attending today's meeting, we share the view of Rep. Charles Boustany (R-La.), who said last September: "We agree on about 80 percent of the issues right now. It's just a matter of hashing out those few areas where we disagree."

That's why we think Republicans should find a lot to like in the proposal President Obama released on Monday. It contains several ideas taken directly from Republican bills, such as letting people save on their premiums if they participate in proven employer wellness programs, a proposal supported by Rep. Mike Castle (R-Del.). Or giving states grants to evaluate medical liability models that can improve patient safety, reduce medical errors and bring down liability premiums, similar to a proposal Sen. Mike Enzi (R-Wyo.) has supported. We know Republicans will support the measures to prevent health-care fraud, such as new background checks for Medicare suppliers and real-time reviews of claims, because they're the ones who wrote them.

The president's proposal also contains insurance reforms that Republicans have supported for years. For example, it would eliminate caps on benefits, a step that has been supported by Sen. Judd Gregg (R-N.H.). Republicans including Sens. Tom Coburn (Okla.) and Richard Burr (N.C.) have backed one of the proposal's key elements: state-based, health insurance marketplaces where families will be able to easily compare insurance policies to find the one that's best for them. The president's proposal would also ban discrimination based on preexisting conditions, a change that Coburn and Burr pushed for insurance plans in these new marketplaces.

To help families afford these plans, the Obama proposal contains tax credits for middle-class families -- an expanded version of a policy that has been advocated by Enzi. It embraces the pooled purchasing options for small businesses championed by Sen. Olympia Snowe (R-Maine). It will allow Americans to buy insurance across state lines, a favorite idea of Republican House members including Paul Ryan (Wis.) and Mark Kirk (Ill.), while preserving consumer protections. And to provide immediate security for uninsured Americans who have preexisting conditions, the president's proposal creates a temporary high-risk insurance pool. That idea was proposed by Sen. John McCain (R-Ariz.) during the 2008 presidential campaign and is now supported by leading Republicans such as House Minority Leader John Boehner (Ohio).

This foundation of agreement reaches all the way down to the basic goals of reform. We all want to slow rising health-care costs. We all want Americans with insurance to have more security. We all want to make coverage more affordable. We all want to transform a system of delivering health care that former Republican House speaker Newt Gingrich has called "overpriced" and "underperforming."

With so much common ground, it would be a shame for anyone to delay needed reforms by insisting on a specific package of changes. That's why President Obama and this administration are going into today's meeting with an open mind. We're ready to hear Republicans' best ideas, and we hope they're ready to hear ours.

By sitting down across from one another with the American people watching and putting aside partisan talking points, we can have the kind of honest conversation about how to solve our health-care problems that can move this debate forward. We are ready to build on our broad areas of agreement, hash out those differences and deliver the real reform we know Americans need. Kathleen Sebelius is secretary of Health and Human Services. Nancy-Ann DeParle is director of the White House Office of Health Reform.

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