The right way to frame the case for healthcare reform

In an interview with Salon, Rep. Rob Andrews, D-N.J., talks about what he took away from healthcare summit

Published February 26, 2010 11:10PM (EST)

On Friday, I spoke with Rep. Rob Andrews, D-N.J., who's playing a key role in healthcare reform as chairman of the House's Subcommittee on Health, Employment, Labor and Pensions. Andrews offered this as one of his major takeaways from Thursday's bipartisan healthcare summit, which he attended:

One thing I was thinking about at the summit, and I think it crystallizes the views of the two parties -- Sen. Alexander started the discussion on their side by telling a story about a man he met in Tennessee. But if I understand the story correctly, the man is married to a woman who has breast cancer. And he's afraid he's going to lose his job, and if he loses his job, he told the senator, it would cost $2,000 a month for health insurance. And the senator used the man as an example of someone who didn't want the bill but did want us to fix the problem.

It occurred to me that what people ought to focus on is that man and what the two sides are offering here. What we would say to him is, number one, we're working like heck to make sure you don't lose your job .... If the man would lose his job, under the plan that we support, he'd be able to get quality health insurance until he finds another job at a cost of about 5 percent of his unemployment benefits or whatever other income he has, which would be affordable. And the fact that his wife has breast cancer would be irrelevant; the insurance company would not be permitted to deny her coverage, nor would they be permitted to raise his premiums exorbitantly because of that.

The question Sen. Alexander needs to answer is: what is he going to give that guy. What's he offering? I think that the record of the summit yesterday really shows that the answer's "nothing." The Republican plan that was put on the House floor in November offers health insurance coverage to three million of the 47 million people uninsured. So the odds are better than nine out of 10 that what Sen. Alexander would have to tell this person is I'm sorry, but maybe later we'll get to your problem. I think that's kinda what this is about, and the public got a chance to see that yesterday. Sen. Enzi had an answer for the guy, Sen. Coburn I think had some answers, Rep. Ryan had some answers. I don't agree with all their answers, but they had answers. Most of the Republicans, though, would just tell this poor man how terrible President Obama is. He may agree with that, by the way, but I think what he's interested in is what's going to happen to him and his wife. That's how I think people will frame this summit, and I hope to have a chance to ask Sen. Alexander about that.

That may be a compelling argument on a human level, and a policy level, but it does seem to lack a little on the political side. The uninsured aren't the people who'll be voting this fall; indeed, nearly all those who voted in the last election have health insurance, or at least had it at the time. So if you make the argument about covering the uninsured, you're really making an argument to voters about helping other people. That doesn't tend to work with the American public; people start worrying that they're going to be giving up something, they're going to be suffering, in order to help those faceless uninsured.

I asked Andrews about that issue; here's his response:

The political issue is not simply the uninsured. It's how the cost of the uninsured affects those with insurance. The 95 percent of voters or whatever it is who have health insurance are paying much higher premiums because they are already paying for the uninsured in their premiums, their taxes. So this is really all about how to reduce the premiums of insured people.

This argument's not about the morality of covering the uninsured, it's about the strategic importance to insured people, the value to insured people, of not having to pay this surcharge they're already paying for the uninsured.

True enough. But probably a good idea for Democrats like Andrews to emphasize that right off the bat going forward.

By Alex Koppelman

Alex Koppelman is a staff writer for Salon.

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