‘Top Line’: Health Care Reform’s Trade-Offs

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After a rough week for health care reform on Capitol Hill, the debate is centering on a series of tough choices about what reform should look like: how to pay for it, whether to create a “public option” — and, more broadly, whether the bill must have bipartisan support to be a success. On ABCNews.com’s “Top Line” today, we spoke with Ralph G. Neas, the CEO of the National Coalition on Health Care, about the state of play of health care reform. Neas — who will testify in favor of House Democratic leaders’ health care bill tomorrow on Capitol Hill — called the House bill “an excellent start,” in part because it includes a public insurance option. Yet he also said it would be “sad” and “tragic” if the final bill doesn’t enjoy support among both Republicans and Democrats. Leading congressional Republicans have declared a public plan that they will not support a bill that includes a public plan. On having a public plan in the House bill, Neas said: “I think it’s good that it is in there; it’s got to be carefully designed so that it’s not weighted against the private insurance industry, but the American people want choice of doctors [and] insurance plans.”"They want freedom from fear in terms of losing what they have. So this gives them a choice of doctors, choice of plan. It also will make sure — the House and the Senate bills — that you cannot be denied coverage because of your age or preexisting condition.  This is all about choice in being able to make sure that you have quality, affordable health care — everyone in America.”In terms of cost, Neas said it’s important that the bill be “sustainable.” “We need not just coverage, not just quality, but we also need to make sure we pay for it, that it’s budget-neutral,” he said.He added, “The most critical thing is to enact health care reform for everybody that has quality and is affordable. . . . But, it would be sad, it would be tragic if it’s not bipartisan. All the major laws in the past — and I come from a civil rights background — were able to garner bipartisan support. If you get the support of both parties, you don’t have to have every Republican, but it would help to have some Republicans join the Democrats to inspire confidence and trust.”"We’ve got to win the hearts and minds of the American people,” Neas said. “After the enactment of the law, it’s gonna be overseen, it’s gonna be implemented, it has to be enforced. You need a really good consensus behind this law.”Watch the full interview with Ralph Neas HERE.
We also spoke with Karen Tumulty, who covers health care and politics for Time. Tumulty said that while the path to a final bill is still littered with obstacles, last week’s congressional action may actually have been a good thing for a bill’s prospects. http://swampland.blogs.time.com/ “Sticker shock is a perfect way to describe it,” Tumulty said. “It was a tough week, but I think that people had begun to underestimate how difficult this whole endeavor was going to be from the start. And interestingly enough, when I was talking to people at the White House, they sounded not only philosophical about what happened last week — they . . . seemed sort of grateful, almost. At one point one official told me ‘You know, it’s good that these guys are beginning to realize for the first time that this is not an intellectual exercise.’ “As for whether President Obama needs to make clear what he favors now, Tumulty said: “I don’t necessarily think that’s the case. I think that if the president gets in the middle of this trench warfare on the Hill, he’s going to be dragged into it. I think it’s far more useful for him right now to be out there making the larger case for health care reform, and to make sure that he is stoking the public demand for it, and that he’s countering the kind of demagoguery that we’re gonna be seeing going on.”Watch the full interview with Karen Tumulty HERE.