How did we get to this moment in healthcare reform and where do we go from here?
We are here in part because some in DC forgot an essential element of life and good manners: "dance with the one who brung ya." The American people who propelled many Democrats and some Republicans to power voted for campaigns that promised transformational change, including universal healthcare. Once the fight between transformers and incrementalists got underway, transformers felt left behind: first, the Wall Street bailouts left less money to help Main Street; then, single payer was off the table before the table was even set; then, word came of the secret deal to undermine the campaign pledge of renegotiating prescription drug prices to benefit more Americans; then, we heard waffling on public option -- all this with no concessions so far from those who didn't bring Democrats to the dance.
We are also here because America struggles with "The Big." We want greatness and yet when we label our enemies, they are Big ___ (fill in the blank) because we sense that they don't share the values of individuals like us. For the past few years, people have expressed fear or loathing or skepticism to Big anything -- and are ditching top-down institutions for local or bottom-up organizations. Ask anyone about Big anything ranging from Big Oil (hate it but like my local gas station attendants) to Big Government (hate it but support my own representatives) to Big Insurance (hate it but appreciate my local agent) to Big Business (hate it but revere small business) to the worst of all, Too Big To Fail. So when Big Change comes along, that's a threat. Any new bureaucracy at a time when we reject The Big brings a shudder to anyone who's ever dealt with a miscreant power tripper in the private sector or public service.
Where to from here? It's not too late for reform -- just dance with the ones who brung ya. We could simplify life with a public option that allows everyone the choice to buy in to Medicare at competitive rates (no new Big Agency needed); requires -- and where needed -- helps subsidize insurance; ends pre-existing conditions, lifetime caps, and dropped coverage; allows renegotiation of prescription drug prices; and, promotes wellness and prevention.
While the dance of legislation can be painful to watch, I still like the Democrats' chances for healthcare reform better than Tom DeLay's on Dancing with the Stars.