Sunday, September 6, 2009
Tonight I collect some of my thoughts and feelings on the ongoing healthcare debate. I’m trying to get back into the habit of working on this site.
One thing that’s been on my mind lately is the issue of healthcare reform. Healthcare reform is a moral imperative and is long overdue. For me, the most urgent facts are the tragedy that befall too many of the uninsured and the underinsured; costs are a secondary consideration. My fear is that any reform Congress and the President Obama pass will not be enough and will only serve to further enrich a broken health-insurance industry.
Unlike many young adults, I have had the need for surgery, and I was briefly completely uninsured after graduating from college. This has helped make me aware of the burdens too many of my fellow Americans must endure—and sometimes do not.
Earlier in Congress’s August recess, the public debate hit a low point with talk of “death panels” from Senator Grassley and Sarah Palin, among others. I respect people's right to disagree, but this is offensive given what's at stake (people's lives). The public deserves a substantial, intelligent debate over real policy, not outright lies. If the Republicans cannot muster this, they are acting as demagogues rather than the kind of opposition that makes a democratic system work. For Americans to get the best possible healthcare reform, we need real, vigorous discussion and a commitment to change; cynical manuevering to hurt Democrats’ chances in 2010 does not accomplish this.
I have no ideological commitment: The gamut of regulatory, market-based, and government-sponsored options need to be considered. However, any reform should meet these criteria:
Under universal coverage, I would include all U.S. citizens, residents (including so-called illegal aliens—but that’s a story for another essay), visitors currently under our jurisdiction, and even the incarcerated. Covering at least all citizens and legal residents is a start, though. From how single-payer healthcare has worked elsewhere, I'd be inclined to that: Private insurance policies could continue to exist as a supplement to or replacement for the public option.
Healthcare reform is not anti-business because, by untying health insurance from employment, we remove an administrative cost and an entrepreneurial barrier; people will be more inclined to take the risk of starting their own business if they do not have to worry about healthcare for themselves or their family.
Systemic reforms of the whole healthcare industry are doubtless also needed: the cost of prescription drugs, the possible distortion of costs and incentives (interesting article in the September Atlantic Monthly), the need for greater use of information technology, and the need to emphasize preventive care. Still, getting everyone covered is a good start.
Matt Wittmann