Health Care

Health care is a complex issue and changes have the potential to hurt people more than just about an other government policy:  I personally knew someone who died as a direct result of losing health care when COBRA ran out.  Because of this people become scared, and at times irrational, when you talk about forcing a new health care system on them.  Reforming health care has to be approached carefully and slowly enough so people have time to adjust.

At one point in my career I worked with (although, not actually for) a really sharp manager who evaluated people into three categories:

  • A:  People who learn from other people’s mistakes.
  • B:  People who learn from their own mistakes.
  • C:  People who never learn.

His philosophy was to hire type A whenever you could and B when you had to.  And avoid type C like the plague…

Let's apply that to health care.

  • Democrats pass the ACA in a big hurry with the slimmest of slim majorities.  Democrats lose the house in midterm elections.
  • Republicans try to reform health care and can't even agree on a plan.  Republicans lose the house in midterm elections.

There is a lesson to be learned here:  If you even try to cram through a health care plan, you lose the midterm elections.

So, how do we reform health care, end up with a good plan, and not lose the midterm elections: 

  • It has to be a bipartisan solution.
  • It has to cover everyone with real health care (note that I say "Health Care" not "Health Insurance").
  • It as to be more efficient and control costs.
  • It has to be developed over time to keep people from panicking.
  • It could be single payer, but doesn't have to be:  The United States is big enough to support multiple competing plans.
  • We should try it on a small scale before switching the entire country over.  We could even try different approaches to see what works best.
  • Rollout has to be incremental.

While we are working on a real plan, we should implement a Medicare option for the ACA exchanges.  This should be rolled out incrementally starting with ACA exchanges that have low participation.  We want to do this incrementally so the Medicare can get it going quickly where it will do the most good.  In addition to shoring up the ACA, this will allow let us try out the Medicare for All approach.