Thursday, August 20, 2009

The Health Care Debate--part 2

Okay, boys and girls, today we're going to just try to get things straightened out so that we can have the conversation about health care (see the last post). Since this is my blog, I'm going to start with a few of my assumptions:

1. The debate isn't so much about health care as it is about health insurance. Those things are linked but they're not the same thing, so we need to be clear.

2. "Socialized medicine" means that the government is the owner and manager of health care delivery. The government owns the hospitals and employs the doctors. (An example would be the VA hospital system.) That model isn't on the table for the general population.

3. "Single payer health care" means that the government purchases health care from the private sector and then provides it to citizens. (An example would be Medicare.) That's not on the table either.

4. What is on the table is a hybrid system by which the government would regulate the private sector more than they have previously been regulated and in which the government would become one purchaser of health care among many.

5. Most Americans have no idea what they are talking about, including me. The health care system is so complex, so interrelated with other parts of the economy, so vulnerable to unintended consequences, so dang complicated . . . it's hard to know what is possible, what is smart, what is workable.

6. Too many Americans are just plain ignorant. I just read that almost half of Americans don't realize that the government runs Medicare. That scares me.

7. The biggest problem may be that most Americans don't trust their representatives to try hard to find workable solutions. We don't trust Congress to do the best they can to understand and then address the health care problems we face. We don't trust that they will think for themselves, stand up to special interests, do the right thing. We don't trust that they will abandon the sound bites for real, complex, collaborative problem-solving.

8. I don't know what the solution is. I believe that making health insurance portable would be a huge step in the right direction. I believe that finding ways to make health insurance affordable to those who are unemployed or underemployed or self-employed is a good idea. I think we can have a uniquely American system of health care that works without resorting to universal health care. I think I'd support that.

9. I also think that many Americans are unrealistic about what health care costs. A woman complained to me that she is paying $164/month for health insurance for her family, with a baby on the way. She felt that was completely unfair. I think she may be just a wee bit unrealistic about what it's going to cost her insurance company for her to have that baby.

10. I want to believe that we can solve all this with honor and grace. I want to believe that we can come together as Americans--in our characteristically messy and boisterous way--and come up with a solution that will work for most of us. I want to believe that the lying and labeling will stop. I want to believe that we can come together and seek the common good. I may be an idiot.


Electric Monk said...

I'll agree with number 5. There are very smart people who spend their entire careers studying how to implement viable health care options. Me doing a Google search and reading a couple of links does not make me as qualified as them to make calls on this.

I VERY much agree with number 7. I'm not sure if it's a Democrat/Republican thing; I suspect it's more of a post-Watergate thing. Many people (myself included) pride themselves on their skepticism, but it's not always a very results-oriented perspective.

Number nine is a very interesting point. As in any insurance program, the costs of the few are offset by the contributions of the many. As a moderately-healthy mid-30s person, I should fully expect to pay more for insurance than what I would pay for healthcare without insurance. Likewise, if (or when) I DO get sick, I should expect my insurance to step up and cover the conditions for which my coverage was designed. It doesn't seem like a particularly difficult concept, and I'm not sure why so many people on both sides have trouble grasping it.

My pessismistic attitude, unfortunately, does NOT allow me to agree with number 10. I can't think of many highly-charged political issues in the last ten years that have been solved with honor and grace. But maybe that's just me...

Jim said...

Your post is very, very clear. Thanks for posting. THe clarity of your thought, helped me clarify some of what I've been thinking and feeling.

Much appreciated.

MJO said...

You and your readers may be interested in The New York Times page that has some interesting columnists writing about the health care debate.

Of particular interest (to me, being a former lawyer) are Glen Greenwald's comments...essentially that, large corporate interests are most likely going to have their way, regardless of whether we have a Democrat or Republican in office. (heavy sigh)