The other health-care reform option

My preference is that House Democrats pass the Senate bill and then run their fixes through the reconciliation process. But I think there is an argument that the current health-care bill has been terribly compromised by the months of controversy, the shady deal with Ben Nelson, the ambivalence of key legislators, the endless meetings with industry players, the wasted time, and the collective freak-out of congressional Democrats in the aftermath of Scott Brown's election.

There is another option.

Democrats could scrap the legislation and start over in the reconciliation process. But not to re-create the whole bill. If you go that route, you admit the whole thing seemed too opaque and complex and compromised. You also admit the limitations of the reconciliation process. So you make it real simple: Medicare buy-in between 50 and 65. Medicaid expands up to 200 percent of poverty with the federal government funding the whole of the expansion. Revenue comes from a surtax on the wealthy.

And that's it. No cost controls. No delivery-system reforms. Nothing that makes the bill long or complex or unfamiliar. Medicare buy-in had more than 51 votes as recently as a month ago. The Medicaid change is simply a larger version of what's already passed both chambers. This bill would be shorter than a Danielle Steel novel. It could take effect before the 2012 election.

If health-care reform that preserves the private market is too complex and requires too many dirty deals with the existing industries, then cut both out. But get it done. Democrats have a couple of different options for passing health-care reform this year. But not passing health-care reform should not be seen as one of them.

