The Tiny Window
By Pat Racimora on August 16, 2009 at 5:15 PM in Health Care, Universal Health Care
I know this isn’t much of a cartoon. But it’s the look that I needed to illustrate what I think you will find much more interesting in my story.
When I was doing health care research for General Wes Clark’s team a few years ago, I gained some fascinating insights into what it would take to get health care reform. It boiled down to a list of factors that should be aligned at a single point in time for it to work, given the complex way we do business in our country.
I think I see why Obama’s team gave it a big push now, but I also believe that they jumped the gun with a too-hasty and risky proposal. See what you think.
Here is what should be lined up in order for a health care reform bill to pass easily through that little window of time. Notice that some are currently in place, but most are too bulky to wiggle through right now. (My comments in italics.)
1. The political landscape needs to be dominated by one party (i.e. who controls decision-making, primarily Congress and the Executive Branch). This one Obama has solidly on his side.
2. The President has the ability to pull people together (“a uniter”). Well, he has a lot of fans and a lot of detractors. And his poll numbers are slipping, which may be part of the reason a premature, ambiguous plan was pushed before the numbers sank any lower.
3. The people are willing to give government a chance to do something right and competently. Awful timing here. People are now watching helplessly as our treasure depletes with no major observable results while also witnessing gross corruption coupled with governmental ineptitude to even detect it.
4. The medical establishment realizes that health reform is inevitable, so it is best to join the team to help shape it than to fight it. (This happened in Canada.) The American Medical Association has endorsed the plan, but the AMA is no longer representative of practicing doctors. Furthernore, Obama’s several recent suggestions that doctors care more about lining their pockets than helping people has not gone over well–at least not with my wonderful and compassionate doctor.
5. A resurgence of working class organizations and unions. This seems to be on Obama’s side. Organizing groups continues on the heels of the stunning organizational capabilities of Obama’s campaign.
6. Our foreign affairs concerns, if not solved, must be stabilized. This depends on who you ask, but a lot of turmoil remains in the Middle East and we are still right in the thick of it.
7. The economy must appear to be on the mend (more jobs, less reliance on foreign oil, etc.). I don’t see many green sprouts yet, and people are still losing homes and jobs.
8. Demands for health reform from powerful social or political groups. Obama has powerful allies here. And powerful opponents.
9. A weakening of current health care markets, such as an increase in “high profile” criticisms of for-profit HMOs. Well, people are pretty fed up, and yet the majority of Americans like the devil’s insurance they have more than the devil’s plan they don’t know.
10. A rise (or resurgence) in national pride and a return to the exercising of fundamental values such as caring for others. Well, I don’t see it yet. Maybe people are too busy trying to survive.
11. A savvy social marketing campaign for health care reform. Given that Obama won the election despite a thin resume, satisfying this factor should have been a piece of cake. But a goofball decision to ask people to report those sending out information that disagrees with Obama on health care directly to the White House, and the more recent unsolicited White House emails from spinmeister David Axelrod, have many people more worried about violations of their privacy. In the meantime, the opposition is spending a small fortune of its own to promote its agenda.
12. A mechanism for rapid communication of ideas/programs that the public views to be in its own best interests and that successfully counters the fear tactics by opponents. We are watching this play out now. It’s quite an ugly (and expensive) spectacle.
13. Ideally some substantial degree of healing between Democrats and Republicans or at least a strong bipartisan agreement that health care must be enacted. Bipartisanship remains as feeble as a newborn calf.
14. Meaningful lobby reform, cutting off to some extent powerful interest-group access. A big Obama promise that has been badly broken is coming back to poke him in his privates. Deals seem to have been made with corporate entities that have a lot more to gain from the plans floating about than do our people.
15. Public financing of elections, again, reducing the influence of powerful interests. Maybe someday, but not even on the horizon. One gets the sense that incumbents care more about retaining their jobs than adjusting our system to make for a more level playing field.
16. Agreement on the shape/scope of a health plan from among various health care reformers. So far the majorities favoring health care reform have been unable to coalesce around a single plan.
17. A significant external shock (e.g., skyrocketing health care costs threatening the collapse of our economy, a major health care scandal, a plague or natural disaster or terrorist attack that injures large numbers of young and healthy middle and upper-income Americans, or other unfortunate occurrences that force change). Well, health care costs are skyrocketing, but the problem with what is being put forth is that no one quite understands it or how it will be funded.
So, out of 17 factors I see no more than a handful that are adequately met at this time. I am one who agrees we need health care accessibility reform, but this time around seems to be way too little way too fast.























