A Winning Issue

The era of big government health reform is over.

Tuesday's election results show that, in race after race, voters supported candidates who advanced fresh ideas for market-based health reform and defeated those who advocated more and bigger government-run programs.

Whether the issue was Medicare prescription drugs, coverage for the uninsured, or rising health costs, an analysis conducted by Galen's Joe Moser found that candidates in competitive races where health care was a key issue were more likely to win when they backed sensible solutions to put consumers in charge of making decisions in a competitive marketplace.

Single Payer: The biggest defeat for liberal reform advocates was in Oregon, where a measure that would have created a Canadian-style health care system in the state was resoundingly defeated by a four to one margin. California, which is planning its own single-payer ballot initiative for next year, may well take heed.

Prescription drugs: The Medicare prescription drug issue also didn't work against conservative candidates as expected.

House Republicans not only inoculated themselves but also made the issue their own and may even have used it to increase their numbers by passing a Medicare prescription drug benefit bill this summer crafted by House Ways and Means Chairman Bill Thomas (R-CA).

At least two House Republicans who supported the Thomas bill were elevated to the Senate: Rep. John Sununu of New Hampshire and Saxby Chambliss of Georgia.

In Maine, Democrat Chellie Pingree, who devised a price-control system for prescription drugs, was selected to challenge Republican Sen. Susan Collins. Democrats thought this issue and this candidate offered their best chance to make the race competitive, but Collins comfortably defended her seat.

Senate Majority Leader Tom Daschle (D-SD) did his colleagues no favors when he failed to lead the Senate to pass a drug benefit bill of its own. Four bills went down to defeat in July.

Even though every member of the Senate who was up for re-election this year voted for at least one of the four bills, voters apparently were angry that nothing passed. The AARP said seniors were going to hold candidates accountable for their votes on the drug bill, and the results suggest they did.

Congress and the White House are very focused on delivering on this issue by 2004, dramatically increasing the likelihood of passage of a Medicare prescription drug benefit bill. Neither incumbent members of Congress nor the president wants to face the voters again without having a signed bill (although Senate rules requiring a 60 vote margin still could block passage).

Members must be careful not to fall into the trap of passing a drug benefit bill based upon unpopular ideas. The benefit must be free of price controls, give seniors a choice of private plans, and put doctors and patients, not bureaucrats, in charge of deciding which drugs to use.

The uninsured: The drug issue wasn't the only one in which conservative candidates were on solid ground. Conservative Democrats as well as Republicans supported the idea of providing refundable tax credits to the uninsured to help them purchase private health insurance.

This idea is a centerpiece of President Bush's health policy agenda and chances improve dramatically that the next Congress will make tax credits or vouchers available to millions of the uninsured to purchase health insurance they can own and keep.

High costs: Many candidates also are heading back to Washington intent on passing Association Health Plans to allow small businesses to gain the purchasing power and freedom from mandates that big companies already have.

In the competitive races where voters focused on issues, advocacy of more and bigger government programs just didn't sell with Americans who are seeking more personal control over their health choices.

Speaker Dennis Hastert said on Wednesday that health care is going to be his top priority in the new Congress. Now it's up to them to deliver on free-market ideas.

Grace-Marie Turner