Friday, August 13, 2010

Something Is Stirring in America

Something is stirring in America. It is a feeling of unrest. The middle class is rebelling against the political establishment. As a country, 61% of our citizens feel we are headed in the wrong direction.

We still regard the U.S. as a special nation, blessed with entrepreneurial talent and a get up and go attitude. We have a vibrant culture. We should be proud of our accomplishments and our heritage, not apologetic. We can do better.

Government is too big. It is spending too much. Somehow, we need to regain our confidence, our belief in ourselves. We must rely more on ourselves, to realize what makes us great comes from below rather than above.

We are a nation with conservative values and a zeal for freedom. We believe individual freedoms are our heritage. We believe in self-responsibility rather than dependence on government. We are the land of equal opportunity, not of equal results. We believe the government that governs less governs best. We are resourceful, and we can do what needs to be done.

We are skeptical of the new health reform law. It smacks of European-style socialism. It is controversial, unpopular, and divisive. One political party supports it. The other major party does not. It has a monstrous price tag, in the vicinity of $2.5 trillion over the next 15 years. It will cause costs to soar, taxes to rise, red tape to proliferate, and the national debt to escalate. Fifty five percent of Americans oppose it , and an equal percentage think it should be repealed.

Its supporters inside the Beltway, a large and growing cadre of professionally trained economists, wonks, and technocrats think they know better than most Americans what is good for the people.

Obama advisors claim the new reform law puts in place three institutions that will reduce the cost of health care and improve care for all. In “Heath Care Reform and Cost Control,” NEJM, August 12, 2010), Peter Orszag, former director of OMB and Ezekial Emanuel, MD, senior advisor to OMB, say the three institutions: IPAB (Independent Payment Advisory Board), the Innovation Center at CMS, and PCORI (the Patient-Centered Research Institute) “will enact many policies specifically aimed at reducing the amount we are spending on health care, and, by changing the delivery system, reducing the rate of growth in health care costs over time.”

“Over time” is the operative term here, and that time may stretch over 20 years. They add, “Morever, by taking a multifaceted approach that includes hard savings plus the mechanisms for creating a dynamic health care system, it enables physicians, hospitals, and other providers to consistently improve outcomes, boost quality, and reduce costs are health care evolves.” These are noble words, but they may be meaningless if the opposition party comes into power and chokes off funds.

What is the alternative? Paul Ryan, the Republican Congressman from Wisconsin has articulated it in his “Roadmap to America’s Future.” It basically consists of pro-market, U.S. style reform antidotes – Medicare and health insurance vouchers, malpractice reform, universal tax-free health savings accounts, and individual portable medical plans across state lines. This may not be answer, but it is rooted in American values.