Let's Talk About Health Care

The effort to reform our health care system has been going on since the time of the Truman administration. For those of us who have difficulty counting, that is more than 6o years. Almost no one doubts that there are serious problems with our health care system and significant change needs to occur. The issue is not a partisan one, as there was a big push for health care reform under Richard Nixon. With legitimate bipartisan concerns about the costs, the inequities, and the problems of the uninsured why can't we get this job done?

We keep seeing the same pattern repeat itself. There is initially great enthusiasm for reform and the polls show overwhelming support for improving the system. Yet as we get closer to making it happen, the enthusiasm wanes, the polls shift, and nothing changes. Clearly the devil is in the details. Yet what details are we talking about, and is the rhetoric getting in the way of completing the task?

The fact is that powerful forces are arrayed against health care reform. These forces don't seem to be interested in the details. They just want to see reform fail. This time we don't even seem to know where this resistance is coming from. The expectation was that this time would be different. Doctors, employers, insurance companies are all at the table. Yet the rhetoric we are hearing is the same or worse than what we heard during the Hillarycare debate. The jargon of socialized medicine, government takeover, and the loss of your own personal physician is alive and well. It seems to me it is one thing to debate the details and hammer out a solution that will forge a meaningful consensus. It is another thing to continue to rant and rave about things that are simply untrue. Such rhetoric suggests a determination to kill any bill as opposed to working for a better bill.

What can be done to get sonething done this year in the face of this opposition? Is the opposition just coming from Republicans in congress who are determined to see this President fail? Are Democrats and liberals also at fault for insisting on a bill that meets their criteria, even insisting on a single payer system which simply does not have enough support to become law? I guess for me the bottom line is what is the point of supporting a policy, no matter how good it may be, if it is not possible to enact it into law? As is often said, 'don't let the perfect be the enemy of the good'.

I believe success will require a bi-partisan approach. What we need to look for is a bill that nobody really likes. Then we will know we have achieved a true compromise. The notion that the Democratic congress should pass whatever it chooses with just 51 votes is not a good idea. The progress that has been made thus far has come from a coalition of all interested parties agreeing to several points. These include, the need to insure the uninsured, the need to reduce costs, and especially the need for a universal mandate. The fact is if everybody doesn't participate you will not have a buy in from the wealthy or the young who feel they don't need insurance. Social Security has worked because everyone is required to pay in. Auto insurance has been effective because you must purchase insurance to operate a vehicle. Universal insurance dramatically increases the pool making it possible to hold down costs and eliminate preexisting conditions. The focus must be what is best for our country and our people, not what is best for me.

Therefore, I believe the Senate compromise being fashioned by Democrat Max Baucus and Republican Charles Grassley is the way to go. To reach an effective compromise each party will have to let something go and recognize they can not have everything they want. I believe the health-care "cooperatives" that are being talked about may offer some interesting possibilities for the bill, especially if they can be worked into some kind of acceptable "public option". After the bill is crafted amendments can be offered to improve the bill. I believe this process is the best way to achieve success. Sixty years is long enough to wait for this program to be enacted. Let's get this job done. If it doesn't come out perfect we can certainly tinker with it in future years, just as the prescription drug program passed by the Bush administration needs some work. The notion, however that we need to take our time and not rush into health care reform is ludicrous. The fact is, time is running out. Let's get this job done, now.