A Republican health care bill of rights

The Republicans are not offering an alternative to the Democratic-driven health care debate. 

They may successfully derail the current dreadful bill, especially if the vote is held after the August recess. But Republicans need to build support for health care reform on their own terms.

I offer the following as a bill of rights (or principles) that could gain populist support and would allow the Republicans to say what they are for.

1. States shall not restrict the ability of their citizens to purchase health coverage from other states.

2. Employers and individuals shall receive the same tax treatment for health-care expenses.

3. All members of Congress, and their staffs, shall be required to purchase their own health coverage.

A few notes on each:

1. One of the current criticisms of our current situation is that there is insufficient competition. (I purchase my own health care and found many providers on ehealthinsurance.com, but let's stipulate that this were true.)

   Health care providers currently must be approved by insurance czars in each state in which they want to offer coverage. There are dozens of insurers that would love to sell to you, but they are legally enjoined from doing so. Let them have a chance, and watch choices increase while prices drop.

2. Our employer-based system of health-care is an accident of history, as well a lesson in unintended consequences. The tax break for employers makes individual coverage expensive by comparison. This hinders labor mobility and makes it harder to move between jobs, as many fear loss of coverage.

   If employers and individuals have a more even playing field with regards to buying coverage, that coverage is more likely to be owned by the individual. This will result in more predictable and consistent coverage over one's lifetime. And by removing a barrier to changing jobs, we'll see more career autonomy and entrepreneurism.

3. This one is somewhat symbolic of course, but important. I do believe that members of government are too shielded from the results of their lawmaking. A little self-interest here will Congresspeople to ensure a healthy market for health-care.

Unlike bureaucrats who prefer "comprehensive" solutions -- those that are so complex as to avoid debate on individual merits -- each of these rights should be debated enshrined in separate bills.

As a political matter, they should be rolled out with in order, each becoming effective one or two years after the previous.

First, establish competition and let the interstate market get some traction. Let consumers see more choices.

Second, scale back the employer tax advantage after consumers see that they have non-employer options. (This is a political calculation.)

Finally, put the Congress on the same footing as the rest of the populace. I could certainly see the argument for doing this first -- it might positively influence debate on the previous -- but it's also symbolic. Best to focus on substance first.

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