When the Shouting Recedes

This week, National Journal provided a welcome reminder that the finger-pointing, bombastic rhetoric and hardened, polarized positions that characterize election-year politics can give way to reasonable discussions and collaborative problem-solving once we get beyond November.

During this election cycle, the Obama Administration has presented hard-line opposition to any kind of Medicare reform that would involve “premium support,” providing seniors with federal financial support they can use to acquire Medicare coverage from competing private plans (or, if they so choose, stay in conventional fee-for-service Medicare).  The issue has been a harsh dividing line between Democrats and Republicans not only in the presidential race, but in Senate and House races throughout the country.

But National Journal obtained e-mail exchanges between highly-respected health care experts David Cutler and Jonathan Gruber and staff of the White House-appointed Commission on Fiscal Responsibility and Reform, the so-called Simpson-Bowles commission.  Cutler and Gruber are professors at Harvard and MIT, respectively, who were health policy advisors to the Obama presidential campaign in 2008 and lent their expertise to the development of health reform legislation.

In their e-mails, Cutler and Gruber gave qualified support to moving toward a premium support plan authored by Congressman Paul Ryan (R-WI) and former Clinton Administration budget director Alice Rivlin.  Cutler said a premium support model should be built on top of the insurance reforms in the Affordable Care Act, while Gruber offered misgivings about trying a choice-and-competition model with seniors before the general population had begun using the new ACA state insurance exchanges, but said “premium support is ultimately where we need to be.”

So, in the long run, what does the National Journal story mean?  Nothing definitively, but it does underscore the point that, once the election smoke has cleared, it’s possible that cooler heads can have reasonable discussions about the future of Medicare and bipartisanship has a chance to take hold.