Wednesday, March 18, 2009

Here I Go Talking About Health Care Again...

Of course, the president is talking about it right now too. Nor is he the only one. It has been in a lot of news and blogs this month. In the New Republic, Johnathan Cohn writes what essentially amounts to a puff piece about President Obama keeping health care firmly in the public eye. From the other side of the political fence, Jenn Q Public (whose awesomeness I may have to concede despite our philosophical disagreements, judging from the excellent way she replies to intelligent arguments intelligently) criticizes the president for excluding the opposition from the discussion. She accuses him of a left wing bent on the topic which I cannot say I am confident he truly possesses. On Huffington Post, Steven Hill exorts the president to move further to the left and embrace European health care reform models... but he wiggles to the right a little in advancing a shared responsibility system of universal insurance on the model of France or Germany rather than true universal health care on the Swedish model. Meanwhile, a trifle more left-ward on HuffPo, Robert Creamer makes a solid point of the need for a public plan to compete with the private insurance system. Back to the right, the Cato Institute published an article by University of Chicago economist John Cochrane which was summarized excellently in Reason. This the same plan Jenn Q Public uses in her criticism of the exclusion of the right from the discussion, noting the author was not invited.

Since I already said it on her blog, I want to say it on my own blog too: I think that plans like that of Professor Cochrane (or the one offered by Suzanne Somers' plastic surgeon) should be represented in our discussion of public health and given their due consideration. I am not saying the solution will come from the right, or even that the free market plans offered by libertarians and conservatives are on the right track. In fact, I believe both Professor Cochrane and Dr. Hanson's plans contain great potential to make the situation far worse. That does not mean they should not be part of the conversation. Clearly, on this topic, there are ideas on the right. They may not come from the political wing of conservatism right now, but the ideas are there. They need to be represented to the policy-makers.

I am a committed supporter of a single-payer system and I believe that single-payer is not being given the consideration it deserves. I believe that President Obama, by removing single-payer from the table in the manner in which many liberals believe he is doing, is cutting off what could be a source of ideas and examples. In this particular area, as I have written before, socialism could be very good for capitalism. Yet it is being dismissed, at this point, with the same cavalier disregard as the ideas from the right.

We are in danger of a politically correct centrism derailing meaningful and lasting reform of the health care system by excluding the radical ideas from both sides. Despite my skepticism of a private sector solution, I want to see a program that addresses all my concerns and if it does then I don't care whose idea it is. The possibility always exists that the best system might be a hybrid in which a government plan competes on an even playing field with private policies, all making each other better (as President Obama originally described in his campaign) and such a hybrid would require ideas from both sides to perfect.

Perhaps most central, however, is the importance of debate in this process. We need radical health care change, on a systemic level, and it needs to be a quantitative and qualitative improvement over the current system to justify the effort and expense. Regardless of the plan that is ultimately adopted, we need the input and critical thinking of both sides. A socialized plan must address libertarian concerns and a free market plan must address the concerns of social liberals. Both sets of concerns are real and valid, when one dismisses all the political polemic attached to them. Quality and patient choice of doctors and facilities are both terribly important, but so are access, accountability, and affordability.

I have spoken derisively of bi-partisanship before and I am not advocating that health policy be tailored to receive broad Republican support in the House and Senate. It will not. In my opinion, even the most conservative policy compromise will ultimately pass on party lines in the House and with the support of only a small handful of moderate Republicans in the Senate. I do not believe the Republican Party believes that health care is a national priority. Michelle Bachmann and Richard Shelby will care more about whether the bill requires health care providers (or, God forbid, the government!) to pay for birth control pills or abortions than they will about whether or not it improves our badly damaged health care system. This is simply to be expected. Even a harshly conservative proposal like the McCain Plan would pass, in its final form, on Democratic votes and the support of its GOP sponsor and a few moderates.

That does not mean, however, that we should exclude those with ideas from the process. Everyone who wants to participate and has something to offer should be invited. Every idea should be heard. Each side should criticize the other and each side should use the other's criticism to address the issues about which all Americans are concerned.

This issue is simply too important to be left to those who wish to pursue politically correct avenues of thought.


Jenn Q. said...

Hey, Chris, keep the compliments to yourself. You'll destroy my righty street cred. ;)

Chris Richards said...

I will have to remember to make a particularly vitriolic attack next time I reference or quote your stuff. As an apology. ;)