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SANDERS: When ‘comprehensive’ isn’t enough
Question of the Day
Lost in the political fracas in the aftermath of the Supreme Court decision, but enmeshed in the still-expanding bureaucratic jungle - and cost - of Obamacare is a fundamental issue: The president's health care plan is another failed attempt at a "comprehensive solution" to complex social problems.
It's not a new phenomenon. Since the French Revolution, the left has sought overarching solutions to every political Gordian knot. In that game of dividing the world into two kinds of people, "us" and "them," no division works better than the one between those who believe in "comprehensive solutions" and those who see incrementalism as progress.
Unfortunately, constitutional scholar Barack Obama falls into the former category. It is why, for example, the president often used to call the Constitution flawed. That it was imperfect, of course, goes without saying. It was why the republic's Founding Fathers immediately negotiated the first 10 amendments for ratification, changes that many of us consider paramount. Of course, the slavery compromise was a blot that haunts us into the 21st century, despite great sacrifices made for progress in better race relations. But the careful cultivation of the Constitution's essence, with only incremental changes through the years, has been its genius.
To have believed, as the administration's leadership apparently did, that all the nation's health care problems could be solved with one fell swoop was ridiculous. Whatever else she may be remembered for, Nancy Pelosi will go down in history as House speaker for her candid analysis: We wouldn't know what was in the health care law until it had passed. But like this writer, I dare say most members of Congress, still have not ruffled through its 2,700 pages, much less scrutinized an endless excretion of "regs" to implement the law now emanating from newly hired bureaucrats. The phrase "unintended consequences" has taken on new meaning.
Because the health care industry constitutes one-sixth of the economy, it not only dictates our lives - life span being a common concern even to the aging Washington politicians with their own special health care arrangements - but it also provides livelihood for many with its $2.6 trillion expenditure.
Americans instinctively have reacted against the law, and I suspect that has less to do with the so-called mandate than conventional wisdom holds. In fact, polls say the young - those most affected by the mandate's penalty/tax - appear, given the continuing paucity of available jobs, remarkably loyal to a president they supported so fervently in 2008, Obamacare or no. What the majority public opinion reflects is the common-sense, American right-of-center hesitation to accept "a pig in a poke," as it used to be called.
But, like the snapping of a rubber band, the cry has gone up - from the ever-ready Bill O'Reilly, for one - that Republican presidential candidate Mitt Romney should offer an alternative to Obamacare. That is just what he must not do. No more comprehensive solutions!
What is required is tossing out Obamacare, followed by pursuit of individual, studied repairs - including experiments at state level - to various aspects of the overall problem.
Some of those repairs already have been started by those closest to reality. Obviously, tidy little monopolistic arrangements among the insurers must be smashed by opening state boundaries to all insurance providers. Are you listening, AARP? Insurance companies themselves seem not too unhappy with the much-trumpeted proviso for "children" to be allowed to stay on parental policies until age 26. (Although there are those among us whose first reaction is, "Whaaat?") The reason is obvious: The young, facing fewer health problems and illness on average, do not upset the actuarial tables.
The cost of emergency rooms as clinics for the uninsured has been exaggerated. Yes, no doubt they add to the overall unpaid bill for uninsured, but there are more important reasons for growing hospital costs. Catastrophic liability will be increasingly expensive with the advent of ever-new technologies. Some states have found pooling insurance for people with pre-existing health conditions as one solution. Having reached an age - "overreached," according to Rahm Emanuel's brother, a self-appointed health expert involved in Obamacare's plans for death panels - I believe I understand the dilemma of expensive testing.
But so-called defensive medicine costs, that is, doctors protecting themselves against malpractice suits and rising malpractice insurance premiums, could be immediately reduced through tort reform. Why shouldn't costs for nuisance suits and ambulance-chasing fall on those who lose such litigation, especially with cases often settled out of court? Are you listening, John Edwards? It might be a way to redeem yourself because your earnings proved you know more than most others about this whole field of legal endeavor.
• Sol Sanders, a veteran international correspondent, writes weekly on the intersection of politics, business and economics. He can be reached at email@example.com and blogs at www.yeoldecrabb.wordpress.com.
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