The more I consider the health care system "reform" currently being debated and opposed so ardently by conservatives, the more opposed I am to it – though not, I suspect, for the reasons they'd quote. In my last post, I said I was agnostic after looking at all the good things that are being proposed. Many of the things Obama and the Democrats are trying to do are not only worthwhile, but morally imperative. However, the very attractiveness of that led me to miss the key point: it addresses the symptoms of the health care malaise, without addressing the underlying problems that create the symptoms. Because of that, it is doomed to fail.
The problems of our current health care system are as follows: 1. It is an extremely complex system, in a situation where simplicity is proven, all over the world, to be more effective and far more efficient. 2. It allows outrageous rewards for malpractice suits, which drives outrageous costs for malpractice insurance. 3. It prohibits the public payer from negotiating prices with the providers. 4. The payer in most situations is motivated by profit (not need) in a system where profit is maximized by denying (not providing) the services needed – effectively rationing health care and reducing choice far more effectively than even this bill would allow.
This bill actually addresses none of these problems. Instead, it takes a quintessentially Republican approach to legislate better results out of a failing system: Government officials meet with corporate industry officials behind closed doors to craft legislation which is then crammed down the citizen's throats. Benito Mussolini would approve; he'd call it fascism – "the merging of corporate and state power." It is a mystery to me why the folks who supported Bush oppose this plan – it is exactly the kind of thing that he would support and promote.
At the risk of being boring and redundant, the solution is simple: 1. To deal with problems #1 & 4 above, expand Medicare to include everyone, and reform the paperwork process to make it simple, easy, and able to process in multiple ways (digital, hard copy, etc.). (This has the added benefit of increasing everyone's choices on doctors, providers, and so on, because every provider is a preferred provider, and there is no out-of-network unless you leave the country.) 2. To deal with problem #2 above, limit malpractice suit rewards. 3. To deal with #3 above, require Medicare to negotiate prices. 4. To additionally deal with #4 above, cover alternative health care (acupuncture, Christian Science, etc.) and preventative care.
The current reform plan on the table operates from the same assumptions and paradigm as the current system, and merely attempts to legislate better results. But without reforming the system, we won't get better results. As Einstein said, "Problems cannot be solved at the same level of awareness that created them." While doing some things to mitigate the symptoms of our current insane system, this plan will hurt vulnerable populations – small business and the middle class – while providing huge, usurious profits to huge, corrupt corporations. It will delay genuine reform. Liberals should stand side-by-side with our conservative brethren and sistren in opposition to it.