It looks like something big is finally going to happen to the American health care system. President Obama seems hell-bent on getting major reform legislation passed and enacted before the snow clouds return to my little corner of New Jersey. He appears to realize that in 18 months he won’t have a strong Democratic majority in Congress, and his relatively high popularity ratings will continue to slide, as they do for almost all presidents. His power and influence as President, along with that of the Democratic Party, will generally wane over the next 3 and presumably 7 years. So Obama is pulling out all the stops to get something big done now.
Most everyone seems to agree that something big is needed with regard to American healthcare. But as to whether our political system can deliver a system that can meet all of the promises that the Democrats are making, and avoid all the pitfalls that the G.O.P. is predicting, just may not be possible. It may be like hoping that you can drive a Ford Expedition from Maine to Florida on one tank of gas. When everyone is getting into the SUV as it is about to leave Portland, the crew might be optimistic. They might say to each other “sure we’re going to make it, no need to take any gas money.” And by saying it back and forth, round robin amidst each other, everyone gets a good, confident feeling. It’s easy for everyone in a group to think “hey, everyone else believes it, so it’s probably true”. Ah, the pitfalls of circular group-think. This little Expedition expedition might get past Boston, might even see the Rhode Island border, but it will finally realize that they’re going to run out of gas.
So just what is the Democratic group-think getting at right now with regard to health care? Well, here’s what the country seems to want:
1.) Everyone will have full health coverage at a price affordable to each family, given their own circumstances. No one is going to be denied health care because of their economic circumstances, and no one is going to have to make radical changes in their lifestyles (bad changes, towards poverty) because of health problems. The USA is finally going to catch up with Europe and affirm health care as a human right, just as education is a right for the young.
2.) There won’t be any rationing. The poor, the working class, the middle class, the well-off, and the super-rich will all get the same care, and will get it when needed. If a rich person could get a $250,000 treatment that would extend his life for 6 months, the poor person will also get it. Maybe the rich person will be allowed to pay for some frills, such as better food and nicer wallpaper in hospital rooms, or the ability to schedule an appointment with a doctor on weekends or at 9PM (instead of having to take a day off from work to see the doc at 11 AM). But as far as medical care quality goes, everyone will get the same thing.
3.) The government will somehow eliminate all the nasty, frustrating things that private insurers now do to sick people in order to control costs. There won’t be any more “payment denied” or “that condition isn’t covered” or long nightmarish struggles on the phone to correct billing errors. The government will find ways, through research and regulation, to control costs without pulling the rug from under the average Jane or Joe who encounters medical misfortune.
4.) And yet, the private sector and competitive markets will still be involved such that the wonderful track record of providing new drugs and treatments will continue unchecked into the future. The forces of competition will also help to develop data and communication systems that will eliminate a lot of the paperwork and red-tape and bureaucratic snafus that currently plague our health care administrative system.
5.) And the doctors will get a fair deal too. They will be protected from unreasonable lawsuits, will be paid sufficient wages to compensate them for all of the effort needed to become a doctor and to keep up with the advances of medical science, and for all the long work hours and 24-hour availability that most of them provide.
6.) Finally, in doing all this, we won’t wreck the American economy. Health care has already grown to more than 15% of our GDP, and will surpass 20% within the next 10 years. If this comes to pass, how is this all going to be paid for? Right now I’m hearing that a few nuisance taxes on the rich, on soda pop, and on insurance companies and health care corporations, will take care of things without any significant impact on the working class and the middle class.
It’s fairly easy right now to pass off the Republican criticism of this dream; their main point is that we will soon become like Canada and England, where in some cases there may be forms of rationing. But at the same time, public polls indicate that over 70% of Canadians and British citizens are satisfied with their health care systems; in the USA, the comparable figure is about 56%. The G.O.P. is crying wolf and is easy to ignore; their sour-grapes are a bit too obvious.
But can Obama and his Democratic colleagues actually craft a system that can do the impossible? No, something is going to give. The USA is going to be plugging away at this problem for many years to come. The system that will be developed by this fall will not be the final system. The slavery issue took around 20 years to resolve; the health care issue might also go past a single decade. Hopefully there won’t need to be a civil war over health care. But there is going to have to be change in the way that Americans live, just as the resolution of slavery made America a different place. Americans themselves had to change in order to resolve the great crisis of slavery; they spent many years in the 1830s and 1840s crafting political compromises attempting to not require any big changes to daily life. Finally, the war showed them that it just wasn’t possible.
Something — I’m not sure what — is eventually going to convince American citizens that health care will require changes in how life is lived. And some of those changes are going to involve sacrifice. As with any national-level sacrifice, the changes aren’t going to be entirely fairly and equitably distributed. People are going to need to put more effort into preserving their own health (better eating habits, eliminate smoking, violent and highly risky behavior, driving cars at reasonable speeds, regular exercising, regular check ups, etc.) And maybe they’re also going to have to get used to somewhat lower living standards in return for greater fairness. The rich are going to have to learn to be a bit less greedy and not threaten to shut the economy down because they can’t become multi-billionaires or receive $1 million management bonuses each year. Sacrifice and patriotism – ideas that weren’t very popular with my Baby Boom generation – will need to make a comeback. Health care is going to be a great on-going struggle, a highly vexing issue over the next decade or two. At some point it may amount to a form of class-war. I may not live to see it all resolved.
I could be wrong here, but I don’t believe that Barack Obama will be remembered as the Abraham Lincoln of health care. That role will hopefully be taken up by some future leader willing to sacrifice political opportunism (or to sacrifice her or his own life, as with Lincoln) for the sake of a greater good. We haven’t seen a president like that in a long time (no, I don’t mean Ronald Reagan; I’m thinking more like Harry Truman or FDR). Hopefully, the kids who are alive today will live to see the woman or man who will go pick up that torch, a torch that will inspire greater wisdom, a wisdom that is the only true cure for the many social maladies plaguing our modern health care situation.
Jim,
I have to say that all the talk about health care reform—at this point—seems to me to be just that, TALK. I keep looking for specifics; and either I am missing a whole lot or they just aren’t there. But in that “all talk and no do” aspect of this discussion, I have to say that what impresses me most is that people actually seem to be afraid of change. I can understand some of that—better the devil one knows than the devil one doesn’t know. On the other hand, having always been one who is willing to take a risk, I find all the worry about how it’s all going to turn out to be uninteresting to me.
I tend to see the health care situation in an analogy to the “flower children” age. Sure, it all seemed impractical and not-doable; yet the basic idea was a good one. Sure, the “flower children” age ended with its own troubles, but I doubt we ever will escape life if we are afraid of troubles and problems that life will bring us. I’d rather have an attempt at doing something good and miss the mark somewhat than never attempt the “doing good” at all.
So at this point in what is a hoped-for goal regarding health care, I tend to think, let me hear more of what the powers that are shaping the system have to say about this from a practical point of view.
As to crafting a “system that can do the impossible”: Well, that won’t happen, but why not aim for that and miss the mark rather than not try at all.
And as to the GOP disagreeing, “crying wolf,” and doing a “sour-grapes” bit: I must say I’m getting very tired of their approach to so many things. I’d truly be interested in listening to some solid ideas the GOP would have to offer.
Let me offer an example of what I mean: One time I turned late into a C-Span program of women discussing the poor of the world. The speaker got up to speak about the starving people in the world, spoke of the very practical measures she would offer to aid the poor of the world. I was fascinated by this group and tho’t how truly altruistic they were and how sincerely concerned. I intently listened to the speaker and found myself thinking, how I might contribute somehow to this group (if only by sending a monetary contribution). At the end of the program the group of women was identified; and to my great surprise, they turned out to be a group of CONSERVATIVE GOP women. Well, I tho’t; this just proves that the liberals don’t have a corner on the market of altruism and concern for the suffering peoples of the world.
However, at this point in the discussion of so many things before the Congress, I do not find the GOP offering much, if anything, in the way of alternative proposals. When the discussion finally gets around to practical issues, I’ll be listening to both sides. And I would hope the GOP come up with some positive contributions of their own—ala the GOP women’s group I heard.
(Continued below.)
Comment by MCS — July 18, 2009 @ 10:35 am
Jim,
I have to say that all the talk about health care reform—at this point—seems to me to be just that, TALK. I keep looking for specifics; and either I am missing a whole lot or they just aren’t there. But in that “all talk and no do” aspect of this discussion, I have to say that what impresses me most is that people actually seem to be afraid of change. I can understand some of that—better the devil one knows than the devil one doesn’t know. On the other hand, having always been one who is willing to take a risk, I find all the worry about how it’s all going to turn out to be uninteresting to me.
I tend to see the health care situation in an analogy to the “flower children” age. Sure, it all seemed impractical and not-doable; yet the basic idea was a good one. Sure, the “flower children” age ended with its own troubles, but I doubt we ever will escape life if we are afraid of troubles and problems that life will bring us. I’d rather have an attempt at doing something good and miss the mark somewhat than never attempt the “doing good” at all.
So at this point in what is a hoped-for goal regarding health care, I tend to think, let me hear more of what the powers that are shaping the system have to say about this from a practical point of view.
As to crafting a “system that can do the impossible”: Well, that won’t happen, but why not aim for that and miss the mark rather than not try at all.
And as to the GOP disagreeing, “crying wolf,” and doing a “sour-grapes” bit: I must say I’m getting very tired of their approach to so many things. I’d truly be interested in listening to some solid ideas the GOP would have to offer.
Let me offer an example of what I mean: One time I turned late into a C-Span program of women discussing the poor of the world. The speaker got up to speak about the starving people in the world, spoke of the very practical measures she would offer to aid the poor of the world. I was fascinated by this group and tho’t how truly altruistic they were and how sincerely concerned. I intently listened to the speaker and found myself thinking, how I might contribute somehow to this group (if only by sending a monetary contribution). At the end of the program the group of women was identified; and to my great surprise, they turned out to be a group of CONSERVATIVE GOP women. Well, I tho’t; this just proves that the liberals don’t have a corner on the market of altruism and concern for the suffering peoples of the world.
However, at this point in the discussion of so many things before the Congress, I do not find the GOP offering much, if anything, in the way of alternative proposals. When the discussion finally gets around to practical issues, I’ll be listening to both sides. And I would hope the GOP come up with some positive contributions of their own—ala the GOP women’s group I heard.
(Continued below.)
Comment by MCS — July 18, 2009 @ 10:35 am
(Continued from above)
As to a change in health care requiring a change in how Americans live their lives: Hasn’t that change started already? Haven’t so many (younger?) Americans finally begun to realize that one cannot live one’s entire life on credit card debt? (Notice the burst of TV programs dealing with this issue.) Hasn’t there been the start of a change in lifestyle for many Americans already?
And I also have to say that I simply cannot find my thinking jumping from people having to learn how to change their lifestyle and/or sacrifice some of their lifestyle to class war. I also don’t even want to HEAR any talk of a president sacrificing his life for the greater good. I fail to see how a president’s sacrifice of his life would lead to the greater good. Unless a word has been left out in the sentence—sacrificing one’s POLITICAL life. But then I still don’t know what I’m missing regarding how Harry Truman or FDR sacrificed their lives—either literally or politically. (And I never liked Reagan as a president and he didn’t sacrifice his life either.)
Actually, I tend to see the U.S. and even the world at the beginning of a new beginning. I will not live to see how it all turns out; but it seems to me how it all turns out is for coming generations. In their own growth as human beings, these future generations must learn how to solve the problems they will have in the future. But I find a period of new beginnings to be a positive thing, a time for new growth either as a person or as a nation. Why deny new growth? I say positive new growth is a good thing and should be anticipated, if not with unalloyed joy (the older a person is the more the person can see the problems involved in risk taking), then with at least with joy and positive support for positive attempts at positive change and growth.
And I still await some SPECIFICS added to what seems to me to be the theoretical ideas being put forth regarding health care.
MCS
Comment by MCS — July 18, 2009 @ 10:54 am
(Continued from above)
As to a change in health care requiring a change in how Americans live their lives: Hasn’t that change started already? Haven’t so many (younger?) Americans finally begun to realize that one cannot live one’s entire life on credit card debt? (Notice the burst of TV programs dealing with this issue.) Hasn’t there been the start of a change in lifestyle for many Americans already?
And I also have to say that I simply cannot find my thinking jumping from people having to learn how to change their lifestyle and/or sacrifice some of their lifestyle to class war. I also don’t even want to HEAR any talk of a president sacrificing his life for the greater good. I fail to see how a president’s sacrifice of his life would lead to the greater good. Unless a word has been left out in the sentence—sacrificing one’s POLITICAL life. But then I still don’t know what I’m missing regarding how Harry Truman or FDR sacrificed their lives—either literally or politically. (And I never liked Reagan as a president and he didn’t sacrifice his life either.)
Actually, I tend to see the U.S. and even the world at the beginning of a new beginning. I will not live to see how it all turns out; but it seems to me how it all turns out is for coming generations. In their own growth as human beings, these future generations must learn how to solve the problems they will have in the future. But I find a period of new beginnings to be a positive thing, a time for new growth either as a person or as a nation. Why deny new growth? I say positive new growth is a good thing and should be anticipated, if not with unalloyed joy (the older a person is the more the person can see the problems involved in risk taking), then with at least with joy and positive support for positive attempts at positive change and growth.
And I still await some SPECIFICS added to what seems to me to be the theoretical ideas being put forth regarding health care.
MCS
Comment by MCS — July 18, 2009 @ 10:54 am