Counter Crass Partisans
Virtually nothing of importance is ever accomplished in Washington without overcoming roadblocks. It's no surprise that the obstacles to health care reform, ranging from inertia to fear mongering, are rising up to test the leadership mettle of the president and the Congress.
The president has to be clear about the fact that comprehensive reform is the only meaningful solution to our top two problems with health care in the U.S.:
1) getting the runaway costs of health care under control and 2) covering the uninsured.
These two issues are inextricably linked: You can't solve one without addressing the other. Our fragmented health care system is the victim of incremental reforms layered onto previous incremental reforms--adding new costs without accountability for better outcomes or systemic efficiencies.
We are the only developed nation on the planet that does not provide universal health care coverage. We spend twice as much per capita on health care as any other country and on many dimensions, such as life expectancy and infant survival, the results are far worse.
The gaps in coverage explain much of the discrepancy. We are paying for the uninsured in the most inefficient, expensive way possible.
People who don't have coverage don't get care early. Instead, they wait until their problems reach an advanced stage, requiring much more costly treatment, often from a hospital emergency room. How much do we pay now for this extraordinarily inefficient and costly care for the uninsured? How much would be saved if everyone had basic coverage, with incentives for prevention, early detection and evidence based medical treatment? The public needs answers to these questions to understand the urgency of reform and the consequences of doing nothing or enacting incremental changes.
The president and leaders in Congress should dispel the myth that cost containment and covering the uninsured are mutually exclusive.
The opposition to health care reform is coming from many directions--partisans who see this as a possible "Waterloo" for Obama, lobbyists for a variety of special interests who want to be exempt from any sacrifice for the greater good, and fiscal conservatives who are not convinced that costs can be contained if coverage is expanded. Engaging the latter group is critical to enacting meaningful reform.
A full-blown campaign for health care reform has to be as substantive as it is tactical. People across the country need to understand in practical terms what comprehensive reform will mean for them and their families, in addition to how the overall system will be improved.
The president's focus should be on educating the public about the necessity of reform that is comprehensive to assure them of care that is both effective and affordable--now and in the long term. This means stepping up aggressively to counter the self-serving arguments of crass partisans and special interests, and working actively with those in Congress, including fiscal conservatives, who are willing to roll up their sleeves to produce a comprehensive plan that addresses the public's priorities.
Doing nothing or taking another incremental step toward reform should not be an option for those who are more concerned about the shaping a better future for Americans than winning political points.
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