A Small Note of Hope on Healthcare.
It’s a heartbreaking world where we have to work so hard to find even a scrap of optimistic news. So let’s take a moment to appreciate this small item from Minnesota.
The state’s Republican Legislature and Democratic Governor compromised on a law that will give needed help to state residents facing steep increases in their health insurance premiums. A real compromise. Involving Republicans and Democrats. Which resulted in actual progress. Try the words out in your brain. They feel good.
The Minnesota agreement stands in stark contrast to events in the nation’s capital, which mostly involved daily photo-ops of the president signing one draconian executive order after another while his sycophants stood behind him clapping their hands and trying to hide the dead look in their eyes. Maybe it’s just me. But every time the president comes on TV I expect to see Princess Leia chained to the leg of his chair wearing a metal bikini.
In Minnesota the compromise came just in time to give residents a little clarity before the January 31 deadline for choosing their healthcare plans. It provides $326 million to offset the premium increases that have been giving indigestion to the individual insurance market. It also includes some changes that Republican legislators have been asking for, like letting for-profit insurance companies sell policies in the Minnesota market. “If we all give a little, Minnesotans will gain a lot,” Governor Mark Dayton said and then he signed the new bill.
Here were elected representatives staying on top of the honest work of governing so the rest of us could get on with living our lives. It was a moment of bright sunshine on a cold January day.
The example from Minnesota may not be immediately transferrable to the larger republic. The Republicans gunning to replace the Affordable Care Act have fallen silent on what sort of changes might be visited on us from the federal level. The primary theme leaking out of a recent Republican strategy session in Philadelphia was a sort of deer-in-the-headlights whimper. One frightened participant offered up an apt description of the disappointing options he saw laid out on the table. “That’s going to be called Trumpcare,” he said, “Republicans will own it lock, stock and barrel.”
The burden of governing is proving difficult for the new crowd in D.C. Expect less than nothing from them. Better we learn to fend for ourselves.
That’s why the early progress in Minnesota may be a bigger deal than we know. A small group of senators led by Bill Cassidy of Louisiana is proposing that congress quit trying to kill Obamacare and leave the decision up to each individual state. The states that are making Obamacare work can keep it. The rest are free to go try whatever it is the Republicans eventually come up with and good luck to them. True believers may snort in derision at the idea of anything so pragmatic. But if the states get behind it, who knows?
Minnesota would do well under such a scenario. We’re given to sensible behavior when left to our own devices. I heard one story about how a group of ordinary Minnesotans helped solve an intractable sewage crisis by sitting the various sides down in a room, setting up a board with a grid outlining the issues, then filling in the square with red each time some consensus was found. A friend who was there tells me that by the end of the day, “There was a lot of red.”
Think about what that sort of sit-down could look like if Minnesotans decided to get ahead of the political class on healthcare. It could include the world famous Mayo Clinic. It could include the country’s largest health carrier, United Healthcare. It could include health sciences people from the University of Minnesota. It could include home-grown policy groups like the Citizens League and Civic Caucus, with their proven abilities to inspire effective non-partisan ideas.
Progress in a place like Minnesota might prove enlightening. Even infectious. The whole country has been led to believe that the bad old days when the only way to get decent insurance was to have a fat company plan are behind us. A state that figures out a way to deliver on that promise will have a competitive advantage. Something the rest of the states will wonder about replicating. Then healthcare will become just one more area where the real action is in the cities and states, while the new government in Washington is left to boil in its own chaos.
That’s my optimistic take on what we can learn from the beginnings of a healthcare agreement in Minnesota. Now I’ll return you to the previously scheduled news flow of political dysfunction.
