Sometimes you just have to wipe the whiteboard and start again.
Is it - and please accept this as a question/suggestion/idea that isn't borne out of a partisan political view - the case that perhaps now is a good time to work out how health care should be paid for? I know that's a really simplistic question but sometimes simplistic questions have to be asked. Call it the curse of the naive if you wish.
If you were given the power to devise a model for health care for your citizens what sort of model would you favour?
That's a good question, and another good one is, what sort of model would your citizens favor?
This process began with broad bipartisan consensus that our health care system needed to be improved, but the WH and Congress squandered that consensus by putting politics ahead of policy. Instead of beginning the process by examining all the ways we might address the things we wanted to change and crunching the numbers to see what benefits each approach might bring us and what each would cost, the President and the Congress decided the important thing was to get the House and Senate bills finished before the summer recess so the law could be signed just before the 2010 campaign season began. Those in Congress who agreed this was the proper way to go about changing our health care system are receiving the treatment they deserve from their constituents at the town hall meetings.
That seems like a pretty fair point. I'd be more fulsome but I don't fully understand the competing policy positions in depth. Could it be though that the proponents of change realised that my suggestion of clearing the decks to start again would be impossible in practice? Could it be that they've decided to work with what they have and to try to achieve a policy position in full acknowledgement that they have to do what's both possible and practical?
I suppose my theoretical suggestion of wiping the board was directed to people who post here rather than putting it as a a position that could possibly be adopted by the legislature. In essence I'm asking if posters here could remove the competing ideologies from the issue of health care, what would it look like?
Speaking of the real world process going on, the polls show that most Americans are still proponents of change to achieve broad health care goals, such as reining in costs, increasing affordable access to health care, increasing portability of health insurance coverage, etc., but the polls also show most people now oppose the House bill and they show that opposition is growing. The point is that almost everyone is a proponent of change, but only a minority, a shrinking minority at that, are proponents of the particular change the President is espousing and which is embodied in the House bill.
The real world debate about this bill, which can fairly be said to represent the President's positions regardless of how cagey his answers to questions are, is all about ideology on both sides at this point and not at all about the benefits and costs involved. How could it have been otherwise since the President and Congress were only willing to discuss achieving changes in our system by adopting elements of a welfare state? From the beginning the process launched by the President and the Congress was motivated by ideological and political ambitions and that is why the opposition it has engendered is also political and ideological. It neither preserves the system we have nor replaces it with another that can efficiently address our needs and goals; rather it is a jumble of disparate elements that is too expensive, impractical and so confusing that its advocates for the most part can only respond to criticisms by mumbling something about private insurance companies being bad.
As for the debate on the message board, if we put ideological biases aside, what is there to debate? Without first crunching the numbers to cost out the relative costs and benefits of the various ways in which we might change our system, we simply don't know enough to decide which way might be best. However, even if we had done all the cost benefit analyses possible, we could still not project very far into the future how these various changes might work out or what effect they might have on our economy with any justifiable confidence, so I would argue that we should only proceed through incremental changes that would first attempt to lower costs and increase access by such discrete measures as allowing health insurance companies to sell national health insurance policies, allow workers to use the company contribution to purchase individual health insurance policies and tort reform in malpractice cases that would cap awards for emotional distress and do away with punitive damages in favor of suspending or revoking medical licenses on a national basis, etc.
To the extent these measures failed to reduce health care costs and health insurance premiums sufficiently to allow everyone to buy health insurance, we might then consider government assistance for those who still couldn't afford it, but to the extent these measures did lower costs and premiums, it would be less expensive for us to offer this aid than it is now. Only after all these measures left us still unsatisfied with the system should we consider making fundamental changes in it.
