Within a 24 hour period, I've spent quality time with wonky Democrats and Republicans in Brussels. The Dems were my fellow Democrats Abroad Belgium (DAB) people, and the lone Republican was a former boss, whose friendship predates any party political differences. Health care reform and the state of the nation were the common themes, appropriate on this day of the SOTU (State of the Union speech by President Obama, his first since taking office).
Health care reform can and should raise the level of emotion in any debate, and the passion was clear when each of us recalled personal horror stories: family members denied care and expat (or binational) Americans who feared returning to their country because they feared prohibitive health care costs. Among the overseas Dems, all of us know that there's another way to approach health care, and that is the social democratic way, i.e., as a basic human right, the way most of the European countries - whether governed by free marketers or socialists - have come to view health care.
But what struck me most was how little passion there was in favor of the options that present themselves to the Democrats in Congress. Yes, Pass the Damn Bill was the reluctant consensus, but only because Democrats need to show something for their year in control of White House, Senate, and House of Representatives. No one expected it to solve all ills, or, beyond a few health care jobs, to create any of the employment that the country needs to earn its way out of the recession.
My Republican friend, meanwhile, saw "health care reform" as a mislabeled good, when what we appear to be discussing is just "health insurance reform," and not a complete fix of even that. How about tort reform, a genteel way of saying that trial lawyers should not be able to game the system to extort hideous "damages" for medical errors. My sister the nurse, going back thirty years, used to wow us with stories of frivolous lawsuits after medical procedures deprived patients of their "psychic powers" - okay, said the juries, here's a few million in compensation. Yes, tort reform is a necessary - and apparently missing - part of comprehensive health care reform.
None of the conversations I've had over the last 24 hours have shaken my belief that we need to fix the broken health care situation in the US. It's a "situation," not a "system," and it's by all accounts "broke" - i.e. broken, and bereft of resources. But the bill(s) - Senate and House - that are now under consideration are not the final answer. They are only the preamble.
Pass what's passable, yes. But don't stop there. If Step One was Medicare in the Johnson Administration, and Step Two the current "health insurance reform" bill, to be passed willy-nilly by the Democrats, Step Three will need to be a truly comprehensive health care reform, one that the Republicans have to be co-partners in adopting.
But Step Three can't happen without Step Two, and Step Two would never have happened without Step One. Health care, like good governance and civilization itself, is a work in progress.
Image from Car Basics.