In her long Senate career, Susan Collins has always been able to find the middle on health care policy.
Look at her position on the Affordable Care Act: She never supported Barack Obama’s sweeping reforms, but in 2017 she cast a crucial vote to save it from repeal, saying such a move would put the security of too many of her constituents at risk.
That didn’t stop her just a few months later from voting for a tax bill that eliminated a key element of the health care law – the mandate that everyone buy insurance or pay a tax penalty – putting Obamacare in danger of being killed in the courts.
In the meantime she has backed a number of health care bills, often co-sponsored with Democrats, that focus on specific aspects of health policy. They are usually good ideas that would have strong support but tend to disappear into the void of a legislative body that can only confirm judges and pass emergency budget stopgaps.
So when Collins and the three candidates trying to displace her took the debate stage Sept. 11, it was no surprise that one of the first questions would be on health care. And it was no surprise that Collins would be ready for it.
Asked what she would do to address the flaws of a health care system that have been exposed by the coronavirus pandemic and resulting economic upheaval, Collins rolled out one of her signature good ideas: price transparency.
Collins is a co-sponsor of a bill that would require hospitals to list their real prices for procedures and make insurers provide accurate and timely information to their customers. If enacted, it would let patients shop around for the best deals, in theory forcing providers to compete on price.
Not knowing how much anything costs until you get the bill is definitely a problem with our health care system. But with millions of Americans still uninsured and millions more opting for high-deductible plans that discourage them from getting anything but emergency care, is it “the” problem?
A much bigger debate on health care policy is taking place inside the Democratic Party, or in this Senate race, between Democrat Sara Gideon and independent Lisa Savage.
Savage supports “Medicare for All,” a national single-payer, universal coverage system, like Canada’s but more comprehensive. Her proposal is similar to the plans promoted by Democratic presidential candidates Bernie Sanders and Elizabeth Warren, which would replace private insurance with a government-run plan. Instead of paying premiums based on their level of coverage, enrollees would pay a tax based on their income.
Gideon has adopted the moderate, incremental approach backed by Democratic presidential nominee Joe Biden, which would expand the Affordable Care Act by, in part, supplementing the private insurance market with a Medicare-like public option. Gideon also wants to use the market clout of the federal government to negotiate lower prescription drug prices.
These are big, meaty issues that affect hundreds of…