Facilitating the Health Care Debate

From what I could tell from my social media streams, only extremists followed the debate.
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I spent most of the day watching the health care summit President Obama held at Blair House today. I've drawn only a few new conclusions.

1) The process needs an independent, trained facilitator. The President isn't one. He's in favor of his own proposals; his party has a dog in the hunt. That reduces his credibility. It also made him talk too much; I bet he took up almost a third of the time after dividing it pretty evenly between the Democratic and Republican members of Congress. The Republicans will use that to flog him in some way.

2) On the other hand, President Obama is very smart. He's up on the issues, and he wasn't reading from notes or a teleprompter. He's immersed in this stuff, and he has been studying all the angles. You don't have to agree with him, but you should admire him for the seriousness with which he approaches the job. In his dreams, he wishes we were post-partisan, although in reality we are not.

3) The Republicans have some good ideas. Most of them have already been worked into the existing bill, but it is difficult for anyone to admit that. They would rather keep on talking about "nuclear options" and "government takeover of health care." There are many things we can all agree on.

4) Everyone forgets that the President was elected on a platform of change. When the Republicans say "the American people don't want this bill," do they know whether the American people want less reform? More reform? No reform? Are they objecting to the process or the product? There's a possibility that most Americans want greater reforms; and at the same time there's a possibility that they don't want change at all (people have a tough time adjusting to change). Fact is, things will change no matter what we do in Congress. Longer life spans, an aging population, an increasing national debt, and more advanced technology will see to that.

5) It was remarkably difficult to watch the Summit on TV. MSNBC was covering the Olympics, and CNN kept breaking in and cutting away. Even C-SPAN only covered the summit live on C-SPAN 3, which not everyone gets with their cable service. At several points I had to stream it, and the streams weren't dependable either.

6) The Republicans keep saying "let's go back to the beginning" and "the American people don't want this bill." What if we did go back to the beginning, and produced a much stronger bill with a nanny-state? I'd bet we would be surprised how many people would want that; there is still widespread support for a single-payer system that would take these decisions off our hands. People are not as prepared to embrace freedom of either markets or lifestyles as we would like to think. Eric Fromm wrote Escape from Freedom in the 1940s about how man attempts to escape freedom: through authoritarianism, destructiveness, and conformity.

7) Nobody mentioned health IT, remote patient monitoring, patient-centered medical homes, or reimbursement changes as ways to cut costs. Why not? Because the discussion centered so much on who has insurance rather than outcomes or patient care. Yet these innovations will probably both reduce costs, and, raise the quality of care. Ah, but they don't have support from doctors, pharma, or insurance companies, because they are less about the free market than about improving quality of life.

8) From what I could tell from my social media streams, only extremists followed the debate. You would think there was no one but #tcot and #p2 who cared.

Actually, everyone cares -- but if your opinion is any combination of R and D, you can't get heard. At least Congress was on its good behavior today; Twitter was not. Normal citizens seem to have covered their ears.

That's really about all I learned. It's not a lot from seven hours of listening and watching.

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