Writings and observations

Mediating toward health care?

The natural tendency by the Idaho Democratic gubernatorial candidate Keith Allred of mediating toward compromise is finding some expression in his new missive on health care. It’s also a demonstration of how difficult, in these times, mediated compromise turns out to be on our hot-button issues.

It emerges in part as kind of response to the incumbent Republican Governor C.L. “Butch” Otter, who recently happily signed legislation directly challenging the new federal health care law and backed a lawsuit against it. A typical stance: Otter against the feds. Or, Idaho Republican (fill in the name) against the feds.

Allred’s statement on the issue seeks to place himself in the middle, more or less: “In recent weeks, both our federal and state governments have passed new laws regarding health care. Neither of them address our health care problems effectively. Today, I want to tell the people of Idaho that a more promising direction is still available to us.”

One that is non-federal law, and non-state law, presumably. Ah, not exactly:

“I prefer finding solutions. Governor Otter’s focus on lawsuits overlooks an important provision in the federal legislation. States can get a waiver from the federal requirements if they establish alternative programs that control costs and increase access better than the federal legislation itself (see Sec. 1321 and Sec. 1332). I’m here today to tell you that when I’m elected governor, I’ll work to do just that.”

The provision is real. It was pushed by Oregon Senator Ron Wyden, and likely is better known in Oregon than in most states. In Oregon, various political people (including legislators) have been talking for some weeks about how the state might use it both to fill in some of the blanks in the current federal law, and to put a more individual state stamp on the effort. One, for example, might (and this appears in a Wyden paper) “Set up a state-run public option that would compete with private insurance companies and hold them accountable. The state could use the total federal dollars it gets to subsidize coverage for low-income folks in the public option as well as in private plans.” There’s a range of possibilities, as long as you meet overall federal guidelines – something like what states have done for years in managing water pollution themselves, but within federally-set limitations.

But we ought to be clear here. What those Oregon political people are talking about doing, like what Allred is talking about doing, is not an opt-out of the federal bill: It is a fulfillment of it. The Wyden provisions amount to a recognition by good number of members of Congress and others in DC that (contrary to their reputation) they do see that good ideas can come from the states, and left them to devise answers to some of the blank spots and to find better ways to do some of the things that were prescribed. Allred’s approach, like Wyden’s, would be an acceptance and a carrying-out of the federal bill.

Allred’s specifics and policies might be, probably would be, different from Wyden’s and Oregon’s. We don’t know exactly what they would be, because his campaign indicated that he would like to develop them through the Common Interest model: to develop a policy brief and then “invite thousands of Idahoans randomly chosen from the registered voter list to review the document and give us their opinion.”

Till then, we have one Idaho gubernatorial candidate (Otter) taking shots at the new law, and another (Allred) who says he will develop policy inside its terms. Politically, this sounds like a framework we recognize.

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