04/09/2012 02:43 pm ET Updated Jun 09, 2012

America Still Needs a Serious Health Care Debate

In three years of street brawl over America's health care system, there's one thing the country still hasn't had: a serious debate over America's health care system.

We have been subjected to everything from snarky BS to thermonuclear rhetoric. We've heard well-crafted talking points and been told that "Obamacare" would end Western civilization as we know it. We've been the targets of a propaganda campaign that would make Herr Goebbels beam with pride. But, what we've never heard from our elected leaders is an honest, fact-based discussion about health care in the United States; what the problems are; what happens in the future if something isn't done; and of course, the best way to fix it.

We know health care costs in the U.S. are by far the highest in the world. We know the U.S. spends more on healthc are per person than any other country on the planet. So, we're paying for the best health care system, right? Wrong.

According to the World Health Organization (WHO), the U.S. ranks 37th out of 191 countries in health care quality. We lead the world in preventable deaths. We're 42nd in life expectancy. Our infant mortality rate is much higher than other industrialized nations. A night in a U.S. hospital costs 5.6 times more than in Japan. In the last few years, health care costs have been listed as a major factor in more than 60 percent of personal bankruptcy filings. Clearly, we're paying a lot more and getting a lot less. Yet we still haven't had a serious debate over our health care system.

I mentioned a propaganda campaign against the Patient Protection and Affordable Care Act, and that is quite literally true. The Republican establishment, their representatives in Congress and the interests behind them have conducted a campaign against "Obamacare" using textbook propaganda techniques. But they've never proposed an alternative. They've never told the public what they'd do. Beyond wanting to cap the amount you can recover in a lawsuit against a doctor who commits medical malpractice, they've never laid out a plan. All they've talked about is killing the Patient Protection and Affordable Care Act. They have never offered their own solution.

We keep hearing that Democrats railroaded the health care reform through Congress without a single Republican vote. We've heard it a thousand times and it has never been true. Anyone who was within a mile of Congress in 2009 witnessed the endless committee, subcommittee and Gang of Six meetings as Democrats tried desperately to bring Republicans on board.

Senate Finance Chairman Max Baucus spent months trying fecklessly to win over Olympia Snowe of Maine, at one point -- I think -- promising her all the land west of the Mississippi. But to no avail. And yet, despite the fact that 216 amendments to the legislation offered by Republicans were considered, they claim they were locked out of the process. By the way, 161 of those Republican amendments are actually in the Patient Protection and Affordable Care Act; not just minor amendments, but language from Republican legislation addressing some of their major issues:

• Allowing individuals, small businesses, and trade associations to pool together and acquire health insurance at lower prices, just as large corporations and labor unions do;
• Giving states the tools to create their own innovative reforms to lower healthcare costs;
• Cracking down on junk lawsuits by providing grants to States to evaluate promising medical liability reform ideas that put patient safety first, prevent medical errors and reduce liability insurance premiums;
• Letting families and businesses buy health insurance across state lines;
• Extending dependent coverage to age 26 and give young adults new options;
• Allowing automatic enrollment by employers in health insurance and allowing employees to opt-out;
• Providing mechanisms to improve healthcare quality; and
• Promoting Community Mental Health Centers to provide access to comprehensive mental health services in a community setting, but ensuring that such facilities provide appropriate care and do not take advantage of Medicare patients or taxpayers.

Not bad for a group that was locked out. The fact that they turned around and voted in lock step against the legislation says a lot more about them than it does the legislation or the process.

We still need a serious debate out our health care system. It can be an argument. It can be loud and rancorous. People can yell at one another. But they have to tell the truth. They can't just make stuff up.

The issue has been in the news nearly every day for three years. Now the Supreme Court has dived in and there is absolutely no telling where their deliberations may lead. It could be an enlightened decision reflecting a thoughtful attempt to interpret Article I, Section 8, Clause 3 of the Constitution and its application to a 21st-century society on an issue that directly affects the lives of millions of citizens. Or it could be a politically-driven stink bomb like Bush vs. Gore.

In the meantime, we've still never had a serious debate about our health care system. There's still time. The matter certainly deserves it. So do we.

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