We find ourselves in the middle of the most ambitious and serious healthcare reform debate since Bill Clinton’s failed attempt during his first term (1993-94). In the face of growing opposition from powerful industry stakeholders and a minority political party whose sole goal is to block any reform, regardless of its form, it becomes increasingly important to understand (a) exactly why we are having this debate in the first place and (b) what the actual proposals are that are being discussed and debated. It is my goal, over the course of a series of blog posts, to explain the underlying necessity for reform, the reason why past reform efforts—dating back to Harry Truman—have failed, and to provide an analysis of the proposals currently on the table and their likely effects.
It has become increasingly evident that a small, yet vocal, minority of boisterous “astro-turf” protesters is attempting to stifle any reasonable discussion and debate over healthcare. These people can be seen (and mostly heard) shouting and acting in a very belligerent manner at town hall meetings across the country, often stifling actual debate (which I suppose is their end goal). Whether or not these people are actually interested in understanding the issues and discussing possible solutions appears very unlikely. Instead, such people are more interested in inciting fear and disseminating falsehoods. (Some of the more laughable include the government mandating, or at least promoting, euthanasia for elderly citizens—the so-called “Death Panels”—and mandatory sex changes for all).
Putting aside this small, angry, and disenchanted minority of far right-wing activists, however, there remains a significant informational gap in the population at large—in no small part due to the antics of said vocal minority, but also due to the Democrats’ failure to adequately explain the reasons for reform and what effects reform will have on the average citizen. Understandably, people fear change. But polling numbers indicate that it is not necessarily a fear of change, but a fear of the unknown that has so many people apprehensive in the face of healthcare reform. More importantly, people are simply ignorant of the basic issues being discussed and the irrefutable brute facts. I suppose it is a symptom of postmodernism that basic definitions and terminology have lost all meaning. For starters, “socialized medicine”—along the lines of the United Kingdom’s National Health Service, where medical equipment and hospitals are government owned and doctors are government employees—is not even remotely being discussed. (What is being discussed can, roughly, be described as socialized insurance, but even that is too broad for the reforms currently on the table, which, as we will see, keep most of the private structure largely intact). Another example I find telling of the current state of debate is that of a man at a recent town hall meeting who urged Representative Bob Inglis, a Republican from South Carolina, to “keep your government hands off my Medicare.”
It is in such an environment that informing people of the facts becomes so important. We may have disagreements as to best reform the health care system in this country, but we must first approach the subject in the same light, out from the murkiness of cable news echo chamber. I propose to outline why reform is needed, describe the current ideas/proposals on the table, and analyze the potential efficacy of such proposals. I intend to do this in a series of three blog posts:
(1) Tomorrow: The twin problems of healthcare cost inflation and unequal access, with a cross-country comparison and analysis.
(2) Future post: The current reform effort, including the leading ideas and proposals, and their potential efficacy in addressing the twin problems of cost and access.
(3) Future post: A brief history of previous healthcare reform efforts and why, with the exception of the Medicare and Medicaid reforms of the mid-1960s, these efforts largely failed.
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