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Originally published November 12, 2009 at 3:49 PM | Page modified November 12, 2009 at 6:01 PM

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Lance Dickie / Seattle Times editorial columnist

GOP clueless as families struggle with health care

Republicans in Congress have nothing constructive to offer as the nation debates how to proceed with health-care reform.

Seattle Times editorial columnist

Democratic passage of historic health-care legislation has Republicans so flummoxed they are talking about term limits again. They have nothing else to say.

GOP House members did not vote for the Affordable Health Care for America Act, neither did they offer a substantive alternative or credible, truthful criticism of what the Democrats proposed. Leaderless R's fend off panic attacks ahead of the 2010 elections.

They have a profound political problem. Next week, the Senate is scheduled to begin debate on its version of the health-care bill. Anticipating a conference committee — no matter how contentious the process — and final passage, Republicans know they are on the wrong side of history.

Their dilemma is simple. No one lives, works or raises a family in the Republican propaganda bubble. Talk-show rants entertain during the daily commute, but have no connection with real life. Ordinary people are worried sick about health care.

House Democrats moved the country toward guaranteeing most all Americans will have health insurance. For all of the complexity of the task, basic elements are widely understood and applauded.

Insurance companies could no longer refuse coverage for pre-existing conditions, or prowl through a patient's medical history for excuses to withhold payment.

All Americans would have to carry health insurance, with subsidies available for those who need help. Universal participation of employers and individuals is basic. The uninsured drive up costs for those with insurance. Insurance exchanges would pool buyers to attract competitive prices and wider choices.

Republicans are left to defend an inefficient, expensive industry offering ever skimpier coverage.

As the national conversation evolved, a mute GOP had no new ideas. The discussion moved on without them. The House bill was endorsed by AARP, the American Medical Association, the American Academy of Family Physicians and Consumer's Union, publisher of Consumer Reports.

In turn, they acknowledged no grievous threats to Medicare, the medical profession's deep frustration with private insurance companies, the support of primary-care doctors, and an assessment of broad consumer benefit and value by a respected consumer advocate.

Middle-class Americans, also known as voters, are shaken by an economic downturn that has left them bruised and scared. Lose your job, lose your health insurance, lose your house. The debilitating condition known as medical bankruptcy, virtually unknown in other countries, is avoided in the new law. Annual patient medical costs are capped.

Lawmakers close the Republican gap in Medicare prescription coverage, and demand the federal government have the ability to bargain for volume discounts on prescription purchases.

Washington Rep. Jim McDermott and Arkansas Rep. Vic Snyder, both Democrats and medical doctors, told me this week they expect the Senate to adopt a bill and for congressional conferees to see health-care reform through to final passage. Americans want it to happen.

From distinct regional vantage points, they view the process as a work in progress that will be continuously tweaked and modified in pursuit of cost containment and medical and technical efficiencies.

Even the 39 Democrats who voted against House passage — including Washington Rep. Brian Baird, of Olympia, who might have three GOP challengers — will get a chance to change their minds. So will chastened Republicans.

Lance Dickie's column appears regularly on editorial pages of The Times. His e-mail address is

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