Sunday, August 9, 2009

Mastering the Art of Health Reform

Mastering any art is a continuing process.

Julia Child, Mastering the Art of French Cooking, Volume 2, 1968

I’ve just returned from seeing Julie and Julia, the film about Julia Child and a young blogger from a later era named Julie who admired Julia.

Julie, a young woman, read Julia’s master work and set out to replicate all of Julia’s recipes in the course of a year in her blog. Like her predecessor, young Julie produced a book on French cooking.

The movie is basically about young Julie’s blogging, cooking, and book making struggles and Julia’s outsized outgoing personality and what went into her classic two volume bestseller, now in its 49th printing, Mastering the Art of French Cooking.

I identify with the film. I’m now into my 922th blog. Out of my blogs has come one book, Obama, Doctors, and Health Reform, and I may do yet another, tentatively to be called, The Rise and Stall of Obamacare.

Similarities exist between health reform and French cooking. Both are Arts, both produce souffl├ęs, some flat and heavy , some puffy and light; both have multiple ingredients, both may result in tasteless disasters along the way, and both are continuing processes based on one’s taste, and trial and error.

Julia Child and her co-author Simone Beck composed two memorable volumes, together some 1350 pages in length, on the Mastering the Art of French Cooking.

The House of Representatives version of Mastering the Art of Health Reform, HR3200, stretches for 1018 pages. God knows how long , Volume 2, now being cooked in the Senate, will be. And no one knows if Volumes 1 and 2 can be reconciled into one eatable whole.

Only one thing is for sure. Julia’s words are infinitely more palatable and digestible than the Congressional legalese can ever hope to be.

Perhaps the most fundamental difference between the Arts of Health Reform cooking and French cooking is that the former involves sausage making while the latter is more about creating beautiful fine foods. One is for the masses; the other is for connoisseurs.

What Julia Child did was to make French cooking accessible and affordable and understandable for Americans using American ingredients.

Perhaps Congress can do the same for health reform.

To Uwe Reinhardt, the Princeton health economist, who is considered to be a master of health reform, reform ought to have these ingredients,

. Financial barriers should not stand between Americans and preventive or acute health care that they sincerely believe will address concerns over a troubling medical condition, in a timely manner, before that condition grows into a critically serious illness.

2. Having received needed health care, no American family should be so financially devastated by medical bills that it cannot meet routine daily living expenses — for example, make utility or mortgage payments on time or finance the education of the family’s children.

3. The future growth in national health spending should be constrained to fall significantly below currently projected spending growth, which has the United States devoting about 40 percent of its G.D.P. to health care by mid-century.

All other goals are subordinate to these three overarching goals, as are the means to reach them.

. Financial barriers should not stand between Americans and preventive or acute health care that they sincerely believe will address concerns over a troubling medical condition, in a timely manner, before that condition grows into a critically serious illness.

2. Having received needed health care, no American family should be so financially devastated by medical bills that it cannot meet routine daily living expenses — for example, make utility or mortgage payments on time or finance the education of the family’s children.

3. The future growth in national health spending should be constrained to fall significantly below currently projected spending growth, which has the United States devoting about 40 percent of its G.D.P. to health care by mid-century.

All other goals are subordinate to these three overarching goals, as are the means to reach them
.

To these goals, I would add - reform ought to appeal to individual tastes. I'm sure Julia would agree.

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