About 15 years ago, I ran across a particularly memorable political cartoon in Cleveland’s Plain Dealer that ran after Mark Hatfield (R–Oregon) had bucked his leadership and cast the decisive vote on a controversial issue in the Senate. In the cartoon, the artist depicted the Senate in three panels as “52 Republicans, 47 Democrats and one Senator.”

Right now, I’m looking for one senator.

Before Republican Scott Brown narrowly defeated Democrat Martha Coakley in a Massachusetts special election to fill the late Ted Kennedy’s Senate seat, health care reform was steadily moving through Congress. Both the House and Senate had passed bills that would drastically expand insurance coverage and cut the federal budget deficit. Negotiations between the two chambers had made good progress toward hashing out a compromise bill, but Brown’s election short-circuited the process.

So Senators, there are now 41 of you who are blocking more than 30 million Americans from getting reliable health insurance. For the love of God and country, won’t just one of you come back from the dark side?

A brief review shows the two bills share the same basic components and will drastically improve health coverage in America.

First, they both ban insurance companies from refusing to insure individuals, regardless of prior health history. Second, they create either state-level or national insurance exchanges. Federal regulations mandate that the plans competing in these exchanges will have to meet certain basic criteria in their coverage, making the plans more transparent for individuals.

Third, not allowing healthy people to opt out of buying insurance spreads risk among a greater pool and lowers premiums for everyone. Therefore both bills include a mandate that individuals must buy some sort of health insurance.

Since it isn’t fair to make poor and working-class people buy insurance coverage they can’t afford, both the House and Senate plans provide subsidies for individuals and families who make up to 400 percent of the federal poverty level.

A nice provision for current college students is that both proposals mandate that family insurance plans provide care for children up to 26 years of age. I have students with autoimmune diseases and heart defects. Without this reform, they risk losing the care they need the second they graduate from college.

Both bills pay for reforms in part by streamlining the Medicare Advantage program, a part of Medicare that currently over-subsidizes private insurers. To pay for the rest, negotiators had nearly reached agreement on a modified excise tax on generous health plans.

Finally, the Congressional Budget Office has estimated that the two plans will cut more than $100 billion from the federal budget deficit over the next decade. These estimates are probably conservative, because the two bills contain a host of experimental provisions designed to cut costs, which the CBO does not credit as saving much money. As a Dec. 14 article in The New Yorker pointed out, however, dozens of small-scale experimental programs drastically improved the efficiency of the American agricultural sector in the first half of the 20th century. There’s no reason they won’t do so for health care over the long haul.

To sum up, the bills expand coverage to more than 30 million people, eradicate the worst abuses of the insurance companies, pay for themselves and may drastically slow the growth of health care spending.

Republican senators, how could you vote against that? Is there any one of you who can find the courage to vote for this bill, which does almost every single thing you have said you want in health reform?

This reform does almost nothing to undermine the basic place of private insurers in the American health care system that many of you seem to think is so sacrosanct. There is no government takeover of health care — only the House bill contains a weak public option that wouldn’t have survived negotiations anyway. In fact, the reform provides private insurers with millions of new customers and billions of dollars in subsidies.

What about you, Olympia Snowe (R–Maine)? You voted for the Senate Finance Committee’s version of health care reform. Why did you bail out on something you know is right?

What about you, George Voinovich (R–Ohio)? Show us that something good can come from the state of Ohio. You’ve always been a real deficit hawk. Why can’t you vote for a program that cuts the budget deficit and expands insurance coverage? Besides, you’re retiring and won’t have to face the wrath of a primary challenge funded by the Club for Growth. Why not enjoy your retirement as the public statesman who helped drastically improve the American health care system?

Finally, what about you, Scott Brown? You voted for almost this exact same reform in Massachusetts as a state senator several years ago. Why not vote for it again?

All America needs is a single senator. Will one of you step up to the plate?

Patrick O’Mahen can be reached at pomahen@umich.edu.

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