While some media conservatives were ranting about the end of American civilization after the health care vote last weekend, there were a few thinking ones who were addressing what the Obama health reforms meant for the country and for people going into the future. True, if you blinked you would have missed the intelligent commentary, but it is out there, and yes, it does have some value in figuring out where to go next.
David Frum’s “Waterloo” post got a lot of attention from both conservatives and liberals when health care passed (it also proved to be the last straw for the American Enterprise Institute, which fired him last week). Frum is a conservative that I certainly don’t always agree with, but argues rationally and speaks what he believes to be the truth even when Republican party leaders do not want to hear it. In college, one of my poli sci instructors put together a list of books by authors from liberal to conservative that he considered to be the best academic writing about politics; Frum’s “Dead Right” was on it, and I dutifully read it, finding it to be quite interesting. The point I’m trying to make is that Frum is the kind of conservative this country needs more of: arguing based on reason and belief instead of name-calling.
After reading his Waterloo post, I added his FrumForum to my RSS feed (joining The American Conservative as the conservative blogs I read, which is another decently written one, although I outright ignore Pat Buchanan’s insane screeds). Sure enough, last week an intelligent post popped up that talked about three important issues that reform will have to address going forward, all of which I fully agree with:
First, employer-based health insurance. I think it’s long past time we totally decouple health insurance from employment. The notion that health insurance is something we expect employers to provide is an accident of history, cemented into place via the tax code. Now that we have nearly-universal coverage for everybody, there is no need for employer-based health insurance. We could eliminate that pretty quickly, but pretty messily, by removing the tax advantages that employer-provided health insurance have, but I think there are better ways to do that. I’m not quite sure who is against changing this. Perhaps unions, who want to be able to negotiate better benefits packages for their workers?
Second, health care value. Spending more has not led to better health outcomes. We have reached the point of diminishing returns, and we need to ratchet back on the wasteful spending that doesn’t deliver. Identifying this, and more importantly, getting rid of it, will be a huge challenge.
Third, improving overall health. Health insurance does make a difference in terms of improving health, but it is certainly not the only thing. Universal health coverage without cutting back on unhealthy activities like smoking, obesity, and a lack of physical activity will just lead to higher health costs with no increase in actual health.
I’m not going to agree with all of the conservative answers to these problems, but it is far better for our country when all sides sit down and agree to take about these real issues, instead of one side talking about death panels and other non-sequiturs. More rational discussion like this, please.