If you didn’t notice, you’re probably dead. But if you have a pulse and still missed the obvious … ahem: The health care debate is once again radioactive. Jazz, Kathy, Robert, Jerry and Dr. E. are among the TMV contributors who have already jumped into this boiling water — and the jumpers are clearly not limited to our humble pages.
I’m not really a jumper; not on this issue; more a toe-in-the-water observer, undecided about the best path forward and woefully unqualified to help resolve the back-and-forth. That said: Here’s what I suspect to be true; these are my three resignations, the ingredients of my “aspirin,” taken at least once a day to dull the edges of the headache I get each and every time I encounter the health care debate.
1. More “free market” is probably not the best answer. For anyone who has mistaken the free market for a fair, gentle coddler of the diseased and disadvantaged, please remove your blinders: The free market is not a coddler; it is a cauldron. In its natural state, its participants compete to boost earnings by increasing revenues and decreasing costs. In doing so, they can generate tremendous wealth and spread it around, benefitting more people than any other system known to mankind. Regardless, there are a number of functions in our society that we have decided, and rightly so, should not be left to the whims of this cauldron; there are some functions for which “boosting earnings” should not be the underlying goal. We intuitively understand that one such function is law enforcement, though we have somehow managed to convince ourselves health coverage is not.
2. More “big government” is probably not the best answer. Every “big” has its drawbacks. Big corporations may be cold-hearted profiteers. But big government — especially big, centralized government — can be (like any big, centralized bureaucracy) rigid, slow, behind the curve, and out of touch. Net: If we skew too much in the direction of either “big,” there will be different but comparable levels of pain, trade-offs, disappointment. Or, in the words of Dr. Darshak Sanghavi, h/t Andrew Sullivan:
The concern isn’t who writes the checks or who writes the bills. The real question is who makes the tough decisions about the limits of the checks and bills—in other words, who ultimately rations the money. Not everybody can have everything, and the sooner we admit that, the sooner our health care debate will get realistic.
3. Don’t short circuit debate with line-in-the-sand pronouncements. If neither “more market” nor “more government” is the best answer, then perhaps there’s a blend of the two that will help. Like the ballyhooed public option … or the public cooperatives that Jazz and others have mentioned … or something else. I don’t know, but I suspect we will severely limit our ability to find the answer — the optimal blend of “bigs” — if we embrace fatalistic, “X or die!” conclusions.
Sen. Conrad seems to get that:
“It is important not to draw lines in the sand and rule out options before they are fully explored. If we do, we could easily wind up with no viable option at all,” Conrad said through a spokesman.
As does the nation’s CEO:
[The President] is not willing to call a public plan non-negotiable at this point. Asked point-blank if he’d sign a bill without a public plan, Obama didn’t want to answer, and after some jousting he made clear he wasn’t really going to. “We are still early in this process, so we have not drawn lines in the sand,” he said.
So there you have it. No answers. No “lines in the sand.” Only aspirin. I don’t know about you, but I feel better already.
UPDATE: Earlier, a commenter on this post pointed to Andrew Sullivan, who pointed to Nate Silver, re: the “public option.” Sullivan later featured this reader dissent on the public option, which goes to my second observation above, i.e., that more “big government” may not be the best answer.