Healthcare: Time to Address the Real Question

There’s a great scene in Disclosure, the 1994 movie starring Michael Douglas and Demi Moore. (Okay there’s more than one.) The one I’m referring to is when Douglas’ character, who has been compromised by Demi Moore’s character via a sexual liaison, realizes he’s solving the wrong problem. Douglas is quietly implored by an undisclosed supporter to ‘solve the problem.’ Douglas, of course, thinks he is solving the problem but subsequently realizes it was the wrong problem. When he finally figures this out he prevails. It all reminds me of how the Democrats and the White House are approaching the healthcare debate: they’re addressing the issue by arguing about the wrong things – albeit ably – and allowing a discussion about what is and always has been a public good to be framed in a construct of an individualistic meritocracy.

In today’s Wall Street Journal, Thomas Frank identifies the same strategic error in ‘Why Democrats Are Losing on Health Care.’ Frank argues it’s ‘the big questions that are tripping them up.’ Understanding that the very nature of insurance is a cooperative, subsidized construct; that there’s no such thing as a truly individualistic healthcare choice; that the connection between merit and healthiness ‘is almost as risible’; and that ‘healthcare is not an individual commodity to be bought and enjoyed like other products … that the health of each of us depends on the health of the rest of us.’ (Just wait for H1N1’s return this fall.) In short, the Democrats have fallen into the wrong discussion – a battle they can win and still lose the war.

The larger issue is (see 8/31 blog), who are Americans? Do we believe in public goods, like security, safe water, law enforcement, etc.? Answer: yes. Is healthcare a public good? Answer: yes. When most of us have too much healthcare, some have none, and the providers are rewarded for over-serving those of us who have insurance – bankrupting our future – everyone loses in the long run. And the long run isn’t so far away.

It’s time to put the larger questions on the table and stop playing able technocrats. It’s time to agree on who we are and what we believe in. Then, the question of 'how' gets much easier.