Is It Possible For America To Look At Health Care Reform Like Adults?

So far we are seeing a lot of predictable political posturing on health care reform but few are willing to approach the issue like adults. The Republicans are uttering the usual talking points, while Michael Steele provides an example of how little they have to say on the actual issues. Obama is pushing hard. Unfortunately the Democrats have been promising a free lunch, and now voters are getting nervous as they realize they might not receive this.

Earlier polls showed voters were willing to support health care reform even if it meant paying taxes. Obama should have taken advantage of this this and appealed to voters’ better instincts–as well as sticking with reality. Instead he tried to claim that health care reform will save money. The problem is that measures such as preventive medicine and computerization of medical records will pay not for health care reform. This might save money in the long run but it will take longer than Obama can Constitutionally remain in office to see real savings from these measures. In the short run (i.e. Obama’s first and potential second term) it will be necessary to spend more money to expand health care coverage to all, increase the provision of preventive medicine, and overhaul the system.

Claims that we can change the health care system without spending money upfront are no more reality-based than the claims we could go to war in Iraq without it costing us very much. We can no more pay for health reform from future savings than we can pay for the Iraq war out of imagined oil revenues.

The Democrats are trying to also say they can pay for this by only taxing the wealthy but there simply might not be enough wealthy tax payers to pay for this.

What Obama should have done back when people were saying they were willing to pay more for health care reform was to come up with a plan where the cost was discussed honestly. Then Obama should have promoted the plan based upon the value to everyone (including but not limited to the near 100 million who are under-insured or uninsured). The selling points would include:

  • Everyone would be assured that they can purchase affordable health care coverage, regardless of their age and regardless of their medical condition
  • Everyone would be assured that they would not lose their insurance because they became ill, or lost their job
  • Insurance prices would likely go down over time, ultimately offsetting initial tax increases

Sure the first two provisions are included in the pending legislation but I wonder how many really understand this. If you want people to support a plan based upon these benefits it is necessary to promote these features which benefit all. Democrats cannot allow the Republicans get away with framing health care reform as primarily a  measure to force those with coverage to pay for the coverage for others (or claim this is a government takeover of health care).

Reassurance that one can obtain and keep affordable health care coverage is of benefit to everyone, both the insured and the uninsured. When we look at the number of bankruptcies in this country due to losing health care coverage and the difficulty in purchasing coverage on the individual market, these are  things everyone can benefit from. As everyone benefits, everyone who is able to should pay the taxes needed to finance this should be paying in. A broad based tax to cover this provides the best chance of actually paying the costs.

Americans want to continue to have among the best subspecialty care in the world, but we cannot continue to have the worst delivery of health care in the industrialized world. Besides access to care, American also desire to continue to enjoy the amount of choice they have had (assuming they had the coverage) and want neither the draconian restrictions of some foreign countries or of some American HMO’s.

Someone needs to talk to the American people as adults about health care in this country–including the need to pay the costs to have the type of health care system most Americans want. Barack Obama has the ability to communicate the information. He needs to talk to Americans like adults instead of pretending health care reform can pay for itself or can be paid for simply by taxing the rich.

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