Health Me, I Think I'm Falling (2009)

 Originally published as a Facebook note September 5, 2009.

President Obama has a big speech on health care to a joint session of Congress this week. I think the venue is a mistake... anyone who's ever watched a State of the Union address knows what circuses they are with all the cheering and booing and stuff. I'd prefer an address from the Oval Office, which would provide some gravitas.

And someone needs to inject some gravitas into this debate in a hurry. The problems of health care are well known, I think: spending consuming an increasing amount of the national economy, putting pressure on government, business and households; 15-20% of the American population uninsured, and many more underinsured whether they know it or not, leaving them vulnerable to any major health problem; and health indicators that are lower than other developed economies even though they spend less and rely on government more.

The answers are not simple. Any technical issue is complex, and this is made more complicated by the multiplicity of interests with stakes in the outcome: hospitals, doctors, insurance companies, pharmaceutical companies, businesses that provide health insurance to their workers, businesses that don't, and national and state governments... as well as ordinary people in their roles as consumers, taxpayers, employees, possibly poor people, and current or future elderly people.

The complexity alone makes this a daunting issue, which is why I thought President Obama's approach of starting the conversation and having Congressional committees negotiate the details was a good one. It is likely that if anything emerges from Congress this time it will be no one's optimal solution, and probably not economically optimal, either.

Still it's an effort worth making. Health care in America, for all its strengths, is rife with problems that are widely perceived as public problems. We can't, say many commentators on left and right, go on living like this.

So it was disappointing, to say the least, to observe the upsurge of playground taunting that erupted at town hall meetings nationwide. Former government officials, who should know better, fanned the flames with absurd stories of death panels for the elderly and, in Sarah Palin's version, retarded children. It seems plain that this was orchestrated, but whoever was orchestrating it clearly touched a nerve. Nerve or not, the name-calling, fist-shaking and rumor-mongering added nothing to the debate, and may well have been the straw that broke the reform effort's back. Furthermore, you don't have to probe too far in the rhetoric of the "death panel right" to find some disturbingly misanthropic statements: the uninsured characterized as losers or leeches, reformers have a socialist agenda, ad nauseum. Normally admirable public officials, like Charles Grassley, who wink and nod at these lunkheads, should be ashamed of themselves. Conservatives who are ambivalent about reform should note that their concerns about future costs and the uncertain impacts of a greater government role in health care purchasing aren't being heard either.