Monday, November 30, 2009

Hooray, Hooray, The Health Care Debate Begins Today

I’m a Democrat and fervent Obama supporter. I voted for him twice (and that was just in the Virginia primary). I’m proud of our President. He has first class economic and healthcare teams. He deserves credit for not postponing health reform. He’s right: it’s simply not tolerable, morally or economically, for a wealthy nation to continue having close to 50 million uninsured people.

Jeff Goldsmith, “The Leaning Tower of Jello: Why No-one Believes Health Reform will be Deficit Neutral,”The Health Care Blog, November 39, 2009

Monday, November 30 - Today begins the bruising Senate health care reform debate between multiple political belief systems. Among participants and issues are,

• Democrats and Republicans

• Socialists and Capitalists

• Liberals, Independents, and Conservatives

• Elitists and the Public

• Moralists and Pragmatists

• Strong and Weak Government Proponents

• Collectivists and Entrepreneurs

• Government and Markets Backers

• Security and Vitality

• Equity and Liberty

• Equal Results and Equal Opportunity

• High Tech and High Touch

• National economy and world economy

• Centralization and Decentralization

• Government help and Self-responsibility

• Government options and Personal options

Given this situation and the issues, you might be interested in my comments on a blog that appeared in The Health Care Blog this day. Its author, Jeff Goldsmith, founded Health Futures in Charlottesville, Virginia and is a well-known and widely respected health care futurist , consultant and commentator. He forecasts health trends and medical technology trends. I respect him. He is sincere, informed, and possesses the gift of language.

He and I have different mindsets. This is my response to his blog of today.
As a Republican who did not vote for Obama, I wish to congratulate Jeff Goldsmith , a self-proclaimed “fervent” Democrat, on a splendid piece of writing.

I’m particularly taken by these insights into,

• American health care as a” vast enterprise where powerful political interests intersect: organized labor, capital markets, major manufacturers, doctors, lawyers, hospitals, pharmaceutical companies, health insurers, state governments, employers large and small. “

• Thomas Jefferson who sought to “forestall tyranny by “designing a weak and divided central government” that “deliberately crippled “ the political system.

• "A bitterly polarized and poorly informed electorate and weak Congressional leadership as a “recipe for fiscal incontinence on a grand scale.”

• The Democratic attitude towards the special interests, which he explained with this Lyndon Johnson quote, “ If you can’t take their money, drink their liquor, sleep with their women and then vote against them when you need to, you don’t belong in Congress.”

As any faithful Democrat should, Jeff argues our political legacy is a weak and divided government, and what we need is a powerful central government with a series of legislative teeth to make special interests bite a series of bullets for the common good.

As a Republican, I would counter,

• It is a good thing we have powerful political interests to protect the economic vitality of business and professional interests to protect us against the most powerful political interest in the country, the Democratic party, that promises economic security for all – an impossible dream.

• Thomas Jefferson was right. He believed the people, rather than being a “poorly informed electorate,” collectively had a practical wisdom that would serve as a bulwark against government infringements on individual liberties. The uprising in town hall meetings, capitol protest marches, and tea parties against mounting federal deficits, false promises of deficit neutralities, and invasive government controls over health care,

• The federal government is already taking a huge bite out of society and the economy. It is running enormous deficits, and as a percent of GDP at a 28.5% is spending money at a record pace without any visible impact on unemployment or other economic woes. What we need are tax cuts to stimulate investment, hiring, and government revenues; health care tax credits for all including making patients responsible for spending more of their own money with more cost transparency; expanding health plan choice across state lines; instituting tort reform and neutralizing the American Trial Lawyers influence on the Democratic Party; and wider recognition that the current health bills being taxing immediately while delaying benefits until 2014.

Let the debate begin in ernest.

As David Brooks argued in a recent New York Times column, “The Values Question,"

“Reform would make us a more decent society, but also a less vibrant one. It would ease the anxiety of millions at the cost of future growth. It would heal a wound in the social fabric while piling another expensive and untouchable promise on top of the many such promises we’ve already made. America would be a less youthful, ragged and unforgiving nation, and a more middle-aged, civilized and sedate one."

"We all have to decide what we want at this moment in history, vitality or security. We can debate this or that provision, but where we come down will depend on that moral preference. Don’t get stupefied by technical details. This debate is about values. “