Is Health Care Too Big to Fix?

Now that the health care bill has been soundly defeated by the election of a single individual to the Senate, the Democratic party is fleeing the House and Senate health care overhaul bills like rats from a burning ship. Sadly Republicans, too, are staying silent with (so far) few rushing forth with their alternative solution to counteract the impasse:

Senator Dianne Feinstein, Democrat of California, said Democrats were assessing their options on health care. “It’s a timeout,” she said. “The leadership is re-evaluating. They asked us to keep our powder dry.”

Mrs. Feinstein said Congressional leaders should simplify the gigantic health care bill and try to pass parts of it that would be understandable to the public. But she also acknowledged that the odds were long for a far-reaching measure. “I think big, comprehensive bills are very difficult to do in this environment,” she said.

The Senate Republican leader, Mitch McConnell of Kentucky, said White House comments on health care suggested Mr. Obama was not listening to the American people.

In Elyria, Ohio, on Friday, Mr. Obama said he was not going to “walk away” from the fight for major health legislation. If the bill becomes law, White House officials said, Americans will see its benefits and will embrace it.

But Mr. McConnell said, “This a clear sign that the administration has not gotten the message, that it’s become too attached to its own pet goals, that it’s stuck in neutral when the American people are asking it to change direction.” He said Mr. Obama should “put the 2,700-page Democrat health care plan on the shelf” and “move toward the kind of step-by-step approach Americans really want.”

Republicans, however, have not come forward with any new proposals, and Mr. McConnell has said he hopes the health care bill is now dead.

Which leads to an ominous question: is health care really too big to reform? With all the special interests at play, all it takes is one well-respected 93 year-old surgeon general to come out and ask some pointed questions to Congress and the President about their actions, and people take notice.

No matter how you cut it, overt rationing of health care benefits is political cyanide. What both parties now understand is the deeply personal nature of health care paired with the special interest affilitations they must nurture have mixed to create an undrinkable potion to assure relection.

So don't look for massive health care overhaul anytime soon. Instead, it will be peacemeal - bit by not-so-tiny bit. Like doctors taking a five percent cut rather than 21%, medical device companies taking a $20 billion tax instead of $40 billion, pharmaceutical companies having to accept competition from overseas, insurers forced to cover cover more of the populace or face extinction, hospital payments continually reduced, and patients having to pay more and getting less. It's our only way forward.

And while these changes will not be very popular to most, the current debate has not been without its benefits. People now understand what's a stake. Health care and its associated costs aren't going away. As the Congressional Budget Office has reminded us:

"...fiscal policy is on an unsustainable path to an extent that cannot be solved by minor tinkering. The country faces a fundamental disconnect between the services the people expect the government to provide, particularly in the form of benefits for older Americans, and the tax revenues that people are willing to send to the government to finance those services. That fundamental disconnect will have to be addressed in some way if the budget is to be placed on a sustainable course."

For now, the people have spoken clearly. We'll have to settle for a slower step-by-step approach. But this issue will not be so easily tabled.

Thanks in part to the internet, we've seen that health care reform has become deeply divisive issue, separating socioeconomic and generational interests. The reality of funding such a massive overhaul without affecting health care benefits and taxes remains a huge challenge. But this division has also made it clear that a one-fix-does-all approach that replicates similar entitlement programs that are already fiscally unsustainable isn't going to work with Americans.

Perhaps we should survey the other countries with viable health care plans and make a case for using the best ideas of the best models out there. Perhaps in this way, we should use a hybrid approach to reform based on data, rather than a special interest path to reform based on scare tactics. Oh, we might have to settle for more than one option for care delivery, like every other successful country in the world with health care for their populace has done, but would that be so bad?

Of course not.

But then, looking to others besides special interests for help at constructing such a model hasn't ever been our modus operandi, has it?

-Wes