Centrist Health Reform

As governor of Texas, George W. Bush essentially dodged health care issues, allowing a patients’ bill of rights to become law without his signature, for instance. He also proposed limits on the expansion of publicly funded health insurance for children that were far stricter than in most other states.

However, in his campaign and now as president-elect, Bush has been guided by health advisors who back bold and often sensible reforms. Bush health policy aide Sally Canfield formulated reforms for her previous boss, Rep. Jim McCrery (R-La.), that were at the heart of some of The Times’ editorial recommendations during the campaign, such as pushing insurers to offer affordable basic policies that do not discriminate by age, gender or health condition.

Some Democrats in Congress are vowing that their top priority next month will be one of the most controversial health reforms--legislation to expand consumers’ right to sue HMOs. First they should seek common ground on other moderate and urgently needed reforms. Three stand out:

* Disabled children’s insurance. Revive a bill by Sens. Charles E. Grassley (R-Iowa) and Edward M. Kennedy (D-Mass.) that would allow the families of children with disabilities to be covered by Medicaid. The bill, SB2274, which had 77 co-sponsors in the Senate, would end the current, perverse system wherein parents of disabled children who leave welfare for work lose their children’s Medicaid health insurance even though no private insurer will take them on at an affordable price. The bill is pro-work, pro-family and pro-taxpayer, but Senate leaders unconscionably killed it earlier this month.

* Health care quality. Health policy experts say that improving quality assurance systems in health care is key to protecting patients and containing health care costs. One model for reform comes from an unlikely source, Bush’s reputed first choice for Treasury secretary, retired Alcoa Chairman Paul H. O’Neill. He is highly respected in health policy circles for spearheading public-private reforms in Pennsylvania that have improved quality by, for example, directing public money only to hospitals that allow detailed scrutiny of their safety records and pioneering robotic tools that help pharmacists avoid medication errors.

* Prescription drug reform. Bush transition staffers have been talking with congressional leaders about his campaign promise to provide full catastrophic prescription drug coverage for seniors who have already spent $6,000 out of pocket. Controversy is swirling over whether states should be free to use new federal drug funding to leverage down drug costs for all consumers, but leaders should not let that separate controversy derail catastrophic coverage, which both Bush and Al Gore supported.

With Texas having the highest percentage of uninsured people in the nation, Bush certainly has yet to prove himself as a health care leader. Nevertheless, he deserves every chance to succeed, and there is plenty of common ground on which to build solid reform.