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Untouchable Fundamental Disagreements in the Health Care Reform Debate

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In the final push for passing his concept of health care reform, President Barack Obama concluded that there is no reason for debating health care reform any further due to "honest and substantial differences between the parties." Why we should not discuss fundamental disagreements; especially, when a major reform hinges on them? Parallel, one may question the integrity of an attempt of passing a significant political reform by a fragile majority, when the meaningful minority strongly opposes its very concept.

One may understand why leaders of the Democratic Party are not eager to get into any debate about fundamental issues. It is puzzling however, that Republicans are not challenging Democrats to debate the "substantial differences."

Punching a big cotton ball
During the televised debate on February 25, President Obama and other Democratic leaders frequently used the term "affordable health care." They brought up examples of personal heart-breaking tragedies that middle class, hard working people endured when dealing with health insurance companies. Those examples were mentioned in the context of supposedly excessive profits of insurance companies and inflated salaries of their executives.

The timbre of these arguments resonated with my memories of my young years in Poland, then a socialistic country. With the skepticism of a youngster, I used to question the principles of socialism, and every time I pointed out that the numbers did not add up and that logic was flawed, I heard in reply about social injustice, about very few enjoying the extreme wealth at the cost of the suffering of the masses. I used to call these debates "punching a big cotton ball," because whatever rational argument was phrased showing that in its very concept socialism causes more problems that it can resolve, no one addressed my arguments, but I was instructed how much good government can do in correcting economic injustice.

The February 25 debate was a great example of punching a big cotton ball. For example, as soon as Congressman Paul Ryan finished his deep knockout punches, the cotton returned to its original shape, and in response, we heard about good things done and planned by the government. Somewhere, in passing, the President said lightly, that this is what we have government to do. No one in the room captured this moment to request a halt to the debate about health care and to start a debate on what the role of the government should be.

Is government a solution?
The President is right when he says, "At stake right now is not just our ability to solve this problem, but our ability to solve any problem." However, we should not close our eyes and minds to the "substantial differences," and go into legislative wrestling. Before going any further, we should explain to the American people the essence of the "substantial differences."

When facing fundamental disagreements, it is time to reach back into the origins of the U.S. political system. It was built on the concept of freedom of an individual in pursuing his or her happiness, and on the concept of limited government protecting these liberties. Thomas Paine wrote:

"Society in every state is a blessing, but Government, even in its best state, is but a necessary evil; in its worst state an intolerable one: ... Wherefore, security being the true design and end of government, it unanswerably follows that whatever form thereof appears most likely to ensure it to us, with the least expense and greatest benefit, is preferable to all others."

Ronald Reagan summarized this in his famous saying, which begs to be repeated today: "In this present crisis government is not the solution to our problem; government is the problem."

Why did no one bring this up at the February 25 meeting? Because they were smart enough to foresee that they could be reminded that for long years when Republicans were in majority, somehow they did not see ever growing government as a problem. Just about three years ago, the immigration reform failed because the majority of Republicans demanded increased government control over the labor market; practically nationalizating of a big segment of it. Knowing that immigration would soon be back on the agenda, Republicans resolutely refrained from bringing arguments that could backfire before long.

If limited government is the underlying concept of our political system, then prior to getting the government involved, we should first ask ourselves, if the same could be achieved just by actions of individuals, without the government's direct participation. If we tune our thinking in this mode, we would soon be surprised how many things could be done better with less government involvement.

Starting from scratch?
Asking to start from scratch, Republicans act as if they just arrived from Mars yesterday and were not around for the last year. Democratic proposals, in all versions, arise from the report prepared for President Obama by the Council of Economic Advisers, titled "The Economic Case for Health Care Reform." Under the pretense of science, this report provides snapshots of the current health care system, with an axiom that the free market failed and the government needs to take over health care in the country. Arriving from this premise, Democrats prepared the original House proposal, then the Senate one, and lastly the President's version. Even if they do start from scratch a million times over, they will still arrive with the same conclusion, which they put in the overriding axiom to begin with.

Instead of asking to start from a blank page, Republicans should pull out at least a few pages with their analysis of the crisis written on them. They do not even need to write it, just pick up the best analysis from what is already written. A treatise by Professors Charles Kroncke and Ronald F. White, "The Modern Health Care Maze: Development and Effects of the Four-Party System" could be a good start. In the summary of their analysis they write:

"Did it ever really make sense to set up a health care system whereby fourth-party corporate employers purchase health care insurance for their first-party employees from third-party corporation, which in turn pay second-party providers for health care products and services?"

It not only sounds complicated; it is. Hence, Professors Kroncke and White ask: "Does any other industry insulate buyers from sellers in this way?" And they conclude:

"The only way to reform our health care system successfully is to destroy the infrastructure that sustains the four-party system. ... Until we reduce government's ability to surreptitiously distort the market forces that drive the health care industry, the juggernaut and other dysfunctional arrangements will continue to plague the system."


Nation in dismay
Health care is just one crisis, besides banking, immigration, education, energy, and almost anything we look at. In theory, we have a free market system. In reality, it is heavily regulated. There is a "substantial difference" in how Americans see and interpret these problems. Some see them as result of unrestrained greed, and look for more government regulations. Others see already existing government regulations as corporate welfare and the source of our problems, and seek improvement in curbing them. Unfortunately, regardless, of which side of the issue they are on, most Americans do not understand the free market concept, and do no know socialism either. Too often confused, sometimes they opt for more government regulations, sometimes for less, depending on other ideological prejudices.

Banking on this perplexity about untouchable and not challenged "substantial differences", the current administration, which has a clear anti-free market, pro-socialistic leaning, has a fair shot in shifting the political system in our country, maybe forever. So far, Republicans leaders failed to challenge Democrats heads on. They do not support abandoning employment sponsored health insurance system in exchange for the free market driven individually purchased insurance. They do not recognize, or are afraid to say it aloud, that individually purchased health insurance would lower premiums, and gradually would invoke market pressure on lowering costs incurred by Medicare. With lower premiums, more Americans would be able to purchase health insurance, lowering the number of uninsured, and those depending on Medicaid. With the revival of the free market, it would be only a matter of time when seniors would ask for the option of buying out of Medicare in favor of commercially available life-cycle health insurance. All these measures combined would lower the burden, which presently Medicare and Medicaid have on Federal and states budgets; Americans would have better health care, and the country would be richer at the same time.

There is only one problem with this rosy picture; with the free market working again, health insurance companies, health service providers, and pharmaceutical companies would finally face real competition, and would need to work much harder to make a dollar. With the November election on the horizon, Republicans are torn apart between their duties to the nation and their fears of ostracizing many lobbyists and major donors.

Republicans entered a risky game, as on one end, they desperately oppose the clearly socialistic health care reform proposal, and -- on the other end -- they avoid presenting free market based solution, which actually could solve our crisis. All due to fears of losing the coziness of their place in the existing Washington constellation. Apparently, crisis did not reach Capitol Hill yet. Republicans need a shake up by a leader of the Reagan caliber. So far, they are afraid of bringing the Reagan name.

The health care reform proposed by the current administration has advanced as much as it did, because Democrats are one-step ahead in comprehending constrains that Republicans put on themselves.