Sunday, December 13, 2009

My Prescription for Health Care Reform

Illustration of the pain pathway in <span class=Image via Wikipedia

Prescription? I can't even mount a description of the process or of the possibility of useful change.

What I do of a morning -- now that the semester is winding down and my shirttail is no longer caught in the buzz saw of academic politics, dragging my butt toward pain and suffering -- is tour the liberal blogs. Some of them say that whatever health care reform gets through Congress will be a betrayal of principle and a practical disaster.

And some say just the opposite, that even if it's not "all good," that you'd be surprised how incremental change is good enough, at least in a fallen world. And, of course, some play with the notion that a failed bill would be better than a bad bill, and that "failure" won't be, not in the long term, midterm elections be damned. (Cue the ironic quotation marks.)

Sigh.

I understand it doesn't matter exactly what I think because even though my $500 contribution or my hand-written letter to Nancy Pelosi has some weight, I know just how much weight that is. But I would like to have an informed opinion, if only so I can say, "I understand" and don't have to sit quiet at the table during holiday reunions.

I understand that as in so many things my thoughts on the topic are probably just a manifestation of my disposition. I probably believe in incremental improvement in health care finance and delivery because I tend to believe in incremental improvement as the answer to any big problem. I probably do not despair at the prospect of a flawed bill rather than no bill at all because I expect to find flaws in every useful thing and really don't want to let the perfect be the enemy of the good.

In short, my views on the topic seem to be a kind of pre-existing condition. I seem to have arrived at a conclusion before actually working my way through the arguments (though I have *toured* the arguments, if you get what I mean). That's one of my goals over holiday break: to fill in the blanks and maybe just maybe decide what I think, not what I feel.