With the opposition party and even the more radical factions within the Democratic Party excluded from the debate on health care reform, the bills which have been produced in the House and Senate are terrible examples of public policy, developed in an echo chamber where bureaucratic micromanagement has replaced creative lawmaking.
Rather than boldly sitting down with all of the parties and thinking through the nation’s health care needs from top to bottom in order to come up with a clear and coherent plan, these bills were produced by a torturous process of agglomeration, gluing together disparate and contradictory ideas into an unwieldy mess.
The objectives were simple. Bring down health care costs, make sure everyone, including the uninsured and those with preexisting conditions, had access to care. Yet despite thousands of pages of rules and loopholes and complexity, the resulting bills both leave a significant number of citizens uninsured and will increase health care costs and the tax burden for citizens substantially.
Worse, they include section after section of unnecessary regulation, burdensome mandates and special exemptions and benefits for privileged groups from unions to those lucky enough to live in Nebraska.
With simple objectives, the solutions ought to be equally simple. Comprehensive measures like a single-payer system or a public option were rejected but would have cut through the clutter and solved many problems. A simple examination of the more successful national health care systems in other countries could have provided a practical model. Australia has managed to provide universal coverage while preserving private insurance and keeping costs at a reasonable level. Why not start there?
What is quite clear is that with single-party control, the dynamic forces which would produce creative solutions were shut down, and there was no effort to produce real alternatives or new ideas. Neither the House nor the Senate bill is an acceptable solution, and no combination of the two will be any better.
The American people need real, comprehensive health care reform. We will only get it if we stop trying to rush through poorly conceived legislation and go back and start over from scratch. We’ve gone for over two hundred years without comprehensive national health care. Surely we can spare a few months to sit down some experts, some industry representatives and even some concerned citizens, and come up with better ideas. That hardly seems like too much to ask on such an important issue.