Where John Weighs in on the Health Care "Debate"

So the way I see this whole health care debate is this: it is not a debate about health care as much as it is a contest of power and political wills. Unfortunately in this country there is little margin left for enlightened discourse. We go straight to shouting matches and frankly, left or right doesn't matter because no one on the right will ever say "Oh yeah, hey you got a good point there and I think I agree with you." and no one on the left is ever going to just stop and say "Wow, good point, I hadn't thought of it like that." Nope, we just want to hack away at each others trunks until the whole forest is leveled.

There is a legitimate debate taking place in the background on the nature of this republic. What is the proper role of government? Conservatives tend to favor a minimalist role and place a great deal of trust in the tenets of political economy, that is, most necessary services can be provided at lower cost and with higher quality when left to the free market. The market provides financial incentives for innovation, entrepreneurship, and, well, plain old hard work. The results (as witnessed by our own history growing from a sleepy colonial backwater to the world’s foremost industrial and financial powerhouse over the course of two centuries) are indisputably favorable. The role of the government then is to intervene when that is an unfair, “failed” market. The prospect of failed markets led to the creation of the SEC, for example, to guard against any one corporation “cornering the market” and achieving an unfair advantage in the marketplace. The global calamity brought on by bank failures in the ‘20s led to the creation of the FDIC, among other regulatory agencies, to hedge against future collapse.

The liberal might tend to see a larger, more interventionist role for government. Regarding market economics, the liberal might understand the "market" to be more than just created goods but might also include what are traditionally thought of as intangibles (like health care, affordable housing or equal opportunity). Medicare and EEOC are two examples of government agencies/programs that were originally created with this broader view of the proper role of government.

An interesting article I read this morning mentions the invisible role of the "free rider" in the formulation of policy positions, especially of those on the right. The "free rider" is the supposed beneficiary of a government project/program who enjoys the fruits of the labor of others without a proportional contribution. The author points out that in some aspects, like providing for the national defense, there are no "free riders" per se; we all benefit equally from national defense. In other areas, like international trade law and consumer protection, there is some private financial interest at stake, winners and losers if you will, but for the most part most everyone generally agrees on the benefits of the programs. Still other programs, especially those associated more closely with the political left, like welfare and universal health care coverage, are rife with perceived "free riders". I'm not saying they are, I am talking only about the perception. The spectra of the "free riders" was a major factor in the reduction and elimination of most welfare programs back in the late '90s when President Clinton and a Republican led Congress agreed to a massive overhaul of the system.

Here’s an interesting matter for contemplation: there are aspects of universal health care coverage that, like the defense department, carry few “free riders”. Take health and wellness education for example. Who could argue that a national program that definitely improves the health and wellness of ALL Americans could somehow be a bad thing? I throw that in there as a good food for thought exercise.

So let’s wrap this up so I can post it to the blog…. Unless and until persons of even temperament, reasonable intellect, and curiosity to learn more (from some source other than TV and blogs) can discuss public policy, I am not at all encouraged that anything useful will ever come of the health care debate. My take is that the people most at fault for screwing up this whole discussion and turning it into the mess it is our elected representatives, and to a more limited extent, the President.

My studies lead me to believe that the most reasonable and effective way to address a lot of our problems in this country is to de-politicize them by putting them into the hands of trained, professional bureaucrats. Seriously! You heard me right friends. Public management professionals at every level of government are specifically trained to SOLVE PROBLEMS...and with surprising elegance and consistency. And just what is their secret? They don’t try to solve the country’s problems overnight or in “one fell swoop”. They use a tried and true incremental approach that respects precedent and moves with caution in policy “baby steps”. That's right, the radical bureaucratic approach is this: identify a problem, consider a range of policy options, select an option, implement the option, observe and evaluate the result, and then either tweak the change, cement the change, or heave it out and go back to your options again. It’s that simple!

I'll take your comments off the air!