It Could be Easier
A writer at The Economist notes:
A CBS News poll from this week shows that most Americans are confused about the health-care reforms being discussed in Congress. Only 31% of Americans think they understand what is being discussed, and I wonder how many of them could pass my little test. The debate over health-care reform has generated so much passion, based on so little knowledge.
… even with perfect media coverage and perfect politicians, should we really expect a large majority of the public to understand the terms of the health-care debate? I can’t think of the last time Americans were asked to consider something so complicated. How many Americans can adequately explain their own health-care coverage? The description of my policy is 42 pages long. I understand it well enough, but don’t ask me about the details.
Most Americans agree that the nation’s health-care system is not performing as it should. But democracy isn’t doing the country any great favours when it comes to solving this problem. In another post, my colleague put forward the idea of random-citizen government. For complicated issues like health care, though, I think the country would be better served by a government of technocrats. Or why not have a panel of experts come up with a health-care bill that would then be put to an up-or-down vote? I know, I’m being unrealistic (and that last idea has shades of HillaryCare). It would be impossible to banish politics or politicians (or much of the media) from the debate. But I think it’s worth pointing out that relying on a body that is generally disdained and answerable to an uninformed and often misinformed public seems like the worst way to go about fixing a complicated problem.
Rather than transforming the nation’s institutions so that we get a better comprehensive health care reform, perhaps our politicians could tackle the problem in smaller pieces, so that citizens and legislators can understand the discrete changes being discussed. This article is accessible to anyone who reads it. Why not use it as a starting point for changes that ought to be made?
Also, Ira Glass, can you hurry up with that episode on health care?
The problem when people start talking “smaller pieces” is that the default choice is expanding coverage because it’s the easiest thing to do. We just make medicaid and medicare bigger. That doesn’t help anything and we just have to keep expanding because costs will keep pricing people out of the healthcare insurance market. Hell, even the current plan is light on cost control heavy on coverage expansion. And i guarantee you that what comes out of the Baucus gang of six will do nothing about cost control at all.
That’s simply where the inertia goes when you start looking to shrink the bill. First cost control measures go. Then we start shrinking the amount of people covered. That dynamic wont change anytime soon. So the goal should ALWAYS be to aim high.
— Derek · Sep 5, 03:38 PM · #
Welfare reform was about “smaller pieces” and didn’t result in increased coverage. Though this may be a case of the third kind of spending versus the fourth. Also…
If you don’t aim high, there will be nothing to shrink, so the dynamic you describe is not an issue. I think you have it exactly backwards.
Also, from the Economist article…
Does this give anyone else the shivers? A common criticism of the healthcare bill is that it’s too complicated for most people, including our representatives, to fully understand, which makes it rather undemocratic. It’s creepy that the Economist diagnoses the problem correctly but decides that the problem is not with the bill, but with democracy.
Good post Conor!
— Blar · Sep 6, 12:39 PM · #
This is a great piece. Very thought provoking. I like the sort of ending that leaves it opn to personal input. Makes it work for just about everyone I think. Nicely done! I’ll subscribe.
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