Senator elect Scott Brown from Massachusetts is offering a different take on the health care issue. Rather than trying a one size fits all, he argues that Massachusetts, which covers 98% of its citizens, should be put forth as a model. The current reform effort, which has yielded a bill that essentially tries to cut costs by limiting disbursements, doesn’t deal with the real problem. The health care system as we know it is unsustainable. Anyone looking at the data and trends cannot deny that. A lot of people think that as long as they’re covered things are OK — but that’s shutting ones’ eyes to reality.
The health care compromise reached in the Senate did not satisfy anyone. I didn’t like it, but argued last month that it was the best possible given the realities of Washington DC, and it would be better to pass something and tweak it later than let health care reform die. Commentators on the left and right disagreed, albeit for different reasons.
Scott Brown’s idea, however, is intriguing — and a sign of how he was able to defeat a Democrat in the state of Massachusetts. He isn’t opposing health care reform, and certainly not giving into the “teaparty” rhetoric of some on the far right. The fact he holds up his own state’s health care plan as a model is something many on the right probably find abhorrent. But he is challenging the Democrats’ effort to create a single national plan.
I think Brown may be right. I believe health care should be a right in advanced industrialized countries. Every other advanced industrialized state has a system that covers everyone, provides quality care, and costs much less than ours. Moreover, our current system is unsustainable, as prices keep spiraling upward. Health insurance costs have gone up 120% since 1999 while average income has gone up only 34%. Projections are the cost could double again within the next six years. Moreover, many people have little or no coverage, depending on their position in society. As the boomers retire, and as the country’s health weakens and addiction to prescription drugs grow, this will only get worse. We can’t sustain our current system. But we can’t agree on a national reform.
Yet the states in Europe are smaller than the US. They do not need a bureaucracy or a network the size of ours, nor do they have such a diversity in conditions as we do from Maine to California to Mississippi to Wyoming. In Germany or France they can have one system. One system for the entire US may be a pipe dream. And, of course, it also appears to be politically out of reach.
There is a clear message in the vote last night in Massachusetts. People want change, and they want the two parties to work together. Talk to most from the Bay State, and Brown didn’t win because he came on like Glenn Beck or Rush Limbaugh. Quite the contrary, he was complimentary to Obama, said he agreed we need health care reform, and staked in independent stance, willing to cooperate with Democrats. That’s what people want. They punished the GOP for its riding roughshod over the Democrats during the Bush years, now they are punishing the Democrats for partisanship in Obama’s first term. Regardless of which party is most to blame — the Republicans clearly didn’t reach out to work with Obama — the public is telling both parties work together. Solve our problems. Stop bickering like children.
Senator elect Brown’s idea of the federal government incentivizing state initiatives to create health care reform at the state level might have the capacity to not only bring substantive refrom, but could also bring Democrat and Republican together. Any real reform needs to focus on improving our health (wellness programs, fight obesity, etc.), cutting overuse of prescription drugs, cutting benefits for operations that are unnecessary, limiting payment for operations that make little sense (extensive unnecessary surgery for an elderly person), and controlling prices.
It’s hard to imagine a federal program effectively achieving these goals. But effective reform could conceivably happen through state initiatives, provided that the federal government helps state have the resources to do this, most obviously in re-directing federal tax money back to the states. Moreover, states could develop different models, and we could compare how each model works — states could learn from each other.
So I retreat from the position that this plan is the best we can do — let’s pass it and tweak it — to an embrace of a new direction, one put forth by the Republican who won in Massachusetts yesterday. Let’s shift from a big national universal reform, to an effort to create universal health care at the state level, with federal support. Moreover, let’s make this the first big bi-partisan effort to help the country recover from over thirty years of political and economic mismanagement.