Universal Health Care, Insurance Reform, Health Care Reform, 2,500 pages, 2,000 pages, yes to a Public Option, no to a Public Option, abortion funding in, abortion funding out, threshold to single payer, or not? Bribes accepted then rejected, bribes accepted and not rejected. Deals with PHARMA, AMA, AARP, Insurance providers; Medicare cuts, taxes, 120 new boards and agencies; new taxes, no new taxes, taxes on the wealthy, taxes on the middle class. Senate leadership saying the absence of getting in on the deals equates to a Senator not doing the job. Higher premiums, lower premiums, rationing, Medicare cuts, costs go up, costs go down, Medicare fix in, Medicare fix out, mandates, constitutionality, arm twisting, finger pointing, ping pong accusations, selective culling of facts; 32 and counting Presidential speeches, months of hearings, town halls and everything short of fisticuffs. Opps, sorry about that fisticuffs comment forgot about the SEIU for a moment there; Mea Culpa.
Taking the 30,000 foot view, FUBAR comes to mind!
Putting aside the specifics of health care legislation; the lesson relearned, should be that central governments are simply BAD at this; proof positive the farther away governance gets from the governed the worse it gets, geometrically. Even governments that have been at the health care thing for a while are bad at it. This process cannot, logically, be analyzed as having been about doing the right thing, or the most efficient thing, or the most non-intrusive thing; it must therefore be about something else; variants of power and application of ideology. It is also, just as clearly, not about using existing resources to their fullest before embarking on unaffordable new entitlements.
We might ponder what the process might have looked like if Congress, in effect, said to the insurance industry, “here is what we want to do, here is how we plan to regulate it, here are our minimum standards, here is what you have to give up to get a shot at the potential market; give us a price, and give us options!” Give us creativity…..or else!
A fair, justified proposal would have eliminated the need for the year long process we’ve observed and eliminated the perception of a health care “takeover”. An unfair offer would have set the context for Congress to pursue other options with a political wind at their backs. The road not traveled is worth of a thought or two, especially when the road you’re on fails the smell test.
We further ponder the absence of actual as opposed to rhetorical leadership; leadership is an omnipresent point of context. Committed leaders adapt and reallocate resources to execute their priorities. If Democrats are truly devoted to health care as the critical issue they say it is and if Republicans are truly committed to fiscal responsibility how about a token five year freeze on earmarks? Perhaps a self imposed 10% reduction on discretionary spending; Good Faith? Leadership commitment? The absence of a thing can be as illustrative as the presence of a thing. And now a scheme to pass a health care bill without the actual requirement to vote on it. We simply “deem” the bill to be passed. Great, I now announce, I’m sorry deem, that I’m six foot three, young and strikingly handsome. Gosh if I’d only known it was that easy.
A wise man once impressed upon me that the best thing to do with power is to arrange your affairs in such a way, that you do not have to use it, he argued that a reversion to the use of power was an indication that a failure or process or creativity had occurred. A lesson Congress might be well advised to contemplate in light of approval ratings and voter discontent.
As a matter of negative reflection Democrats have, inadvertently, made the best of all arguments for market solutions. The absence of at least a swing at threshold market based solutions invariably ends up looking like the rough equivalent of monkeys chasing a beach ball.