How to End the Shutdown - Commentary from Senator Durenberger

Senator David Durenberger shared his thoughts on the Affordable Care Act, the government shutdown and health care reform in a commentary from the National Institute of Health Policy here at the University of St. Thomas. Presented here are a few highlights. Read his complete commentary.

October 1 was the beginning of an exciting new journey for health policy reformers...Given the partisan nature of the attacks on both the passage and the implementation of the new law.

The rebuilding of health care in America did not start with the "glitchy" insurance exchanges.  It began in communities across this country years ago. It began with the consolidation and integration of physicians, physician groups, and hospitals in places like Minneapolis-St. Paul and with the "disruptive technology" of retail clinics, urgent centers, and health information apps.

The Affordable Care Act adds a unique dimension to U.S. health policy.  Something that is common to every developed nation's policy.  National goals for health policy.  The goals reflect public opinion regarding the most appropriate way to a healthier America and more affordable, accessible, high quality health care.  They reflect "reformer" activity in many communities across the country. Goals are a means to bring elected policy makers from all parts of the country and both political parties closer to comparing inter-governmental approaches to:  Healthy people, healthy communities, and a value-based health insurance and care provider system.


Which brings us to the sorry state of current affairs.  The national party of "conservatives" claimed Obamacare violates their "conservative" principles. They have managed to convince many Americans that the new law, not the extraordinary cost of our health care (twice the OECD average for less health), is the biggest spending problem they face.  Elected Republicans at the state level have done everything they can to throw sand in the gears of Medicaid expansion and the tax subsidies that come with the introduction of consumer choice health  insurance exchanges; so they can point to the "glitches" in launching an electronic market place as, what Speaker Boehner calls, "an unmitigated disaster".

A national disaster which justifies shutting down the national government.  As we have recently discovered,  see the NYT article here, this was a plot hatched shortly after the 2012 elections by, among others, my old friend, Reagan Attorney General Ed Meese, and his buddies, the billionaire Koch brothers. With the help of all the usual suspects from former Sen. Jim DeMint and Heritage Foundation to former Republican leader Dick Armey and Freedom Works.  This campaign is now in the "blame the shutdown on the President who refuses to negotiate with us" phase.


Consider the fact that Republicans on the many committees of health policy jurisdiction in Congress have never been willing to negotiate improvements.  Their best known "improvement" is a $30 billion tax cut over ten years for one industry.  Medical devices. They cannot come up with off-setting savings without shifting the $30 billion to the rest of the health system including health care patients. The device industry resists any alternative, like public financing of value-based medical devices.

It would be a serious mistake for the President to negotiate a delay of or changes in the law under the national economic crisis conditions Republicans have created.  There are reasonable Republicans in the Senate and in the House and among the Republican Governors with whom the White House has already engaged and will continue to engage on this subject.  It is up to Speaker Boehner and his leadership team to do what Mitch McConnell and the majority of Republicans in the Senate did last week. Provide some realistic leadership.

Cut a deal on the FY 2014 budget and the debt ceiling in exchange for the President's commitment to engage over the next eight months on entitlement, tax, and health policy reform. We all know it's an election year and Republicans in the House have pinned their re-election plans on defeating Obamacare.  In the current partisan political environment, and with public confidence in Congress at historic lows, it looks impossible.

Read Durenberger's complete commentary.