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Obama's summit

REHABILITATING HEALTHCARE

At Thursday's meeting on health reform, the focus should be on reining in rapidly rising costs.

February 23, 2010

President Obama unveiled a detailed proposal Monday for reforming the U.S. healthcare system, confirming that the bipartisan summit Thursday won't be an exercise in starting from scratch. Instead, he offered a fully fleshed-out plan based on the existing Democratic bills, and challenged Republicans to release a comprehensive counterproposal. It was a put-up-or-shut-up maneuver designed to set the GOP on the defensive and get the reform effort back on track. Unfortunately, the administration missed the chance to go further than the House or Senate to solve the biggest threat faced by most Americans: the rapidly rising cost of healthcare.

House Minority Leader John A. Boehner (R-Ohio) wasted little time blasting the White House, saying that the president "crippled the credibility of this week's summit" by working off the Democrats' bills. But when Obama invited congressional leaders from both parties to offer their best ideas, he never promised to abandon the principles behind the reform effort. As the president has said several times, the administration is committed to extending insurance coverage significantly, improving the quality of care and controlling costs. A few Senate Republicans have embraced those principles. But party leaders seem content simply to slow the increase in cost. The leading GOP proposal to expand coverage and improve efficiency is half-hearted at best.

All the same, Obama hasn't convinced the public that the problems in the system justify such a costly overhaul. That's one reason we would have preferred to see him offer more vigorous provisions to rein in expenses, particularly by requiring Medicare and Medicaid to adopt any successful techniques developed by the Senate bill's many cost-control demonstration projects. One new feature in the White House's draft that we welcome is a ban on drug makers paying rivals to delay generic versions of prescription medicines. But the more ballyhooed initiative to have federal bureaucrats review insurance premiums -- while it might make it harder for insurers to raise rates as sharply as Anthem Blue Cross wants to do in California -- wouldn't address the forces driving up the cost of medical care.

Overall, the proposal is aimed more at bringing Democrats together than attracting Republican support. Its cost controls certainly can be improved by adding some of the GOP's ideas for empowering consumers and injecting market forces into healthcare. We hope Republicans bring those ideas to the table Thursday. Rather than having an all-or-nothing debate over comprehensive reform, we should be combining the best ideas for how to do it.

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