Alaska editorial: Screaming won't fix health care woes

Reform is serious, complex, difficult business

Posted: Friday, August 21, 2009

What's happened to the debate over health care reform? Why are some people so angry? Do they actually believe that health care reform will include "death panels" to refuse care to the elderly and disabled? Do people who rail against "socialized" medicine realize that we already have government-run programs, most notably in the form of Medicare?

How many seniors - despite the problems we have in Alaska - want to give up Medicare because it's "socialist?" Are people really happy with the status quo: the escalating costs and a system that rations care depending on the quality of the coverage you, or your employer, can afford, the fine print in your policy and the availability of doctors and nurses? Do most Americans want our health care system to stay just like it is?

That's hard to believe.

Demonstrations are as American as apple pie - and, provided they're peaceable, protected by the Constitution. Long may it be so. But let's recognize that it's always easier to attack the other guy's ideas than to come up with better ones yourself. While shouting confrontations feed the insatiable news beast and make dramatic YouTube fare, they're also a distraction from the hard work of actually conceiving ways to deliver better health care to more Americans.

We're not Europe, or anywhere else. What we want is a health care system that gives us coverage for all, while controlling costs and preserving freedom of choice.

The challenge is to balance those three elements, make health care available to everyone, figure out how to pay for it and do so in a sustainable, fair manner.

First, agree on the goals.

Every American should have access to good-quality health care.

We need to figure how to pay for that care - and everyone should contribute. Yes, the rich should pay more. But to provide care to everyone will require everyone to pitch in.

We need to find ways to slow the huge increases in the cost of health care or, better yet, bring those costs down.

We need more primary-care doctors and nurses.

We need an honest, forthright debate about how best to do these things. Let's move beyond bumper-sticker slogans shouted at congressmen. That gets us nowhere.

Similarly, proponents of reform, whether radical or modest, need to be forthright about what those reforms will mean - especially who will pay, and how much. How will coverage change? How will any new federal rules change the health insurance market and the quality of medical care? Recognize that the current system works in some ways, so let's not throw out everything.

Where there are winners and losers, explain who and why.

Most Americans would support a program to extend care to those who don't have it, provided the burden is fairly shared and sustainable. Most Americans want as much choice as possible in their health care decisions, and most Americans want to stop the escalation of health care costs.

Screaming won't get us there. Health care reform is serious, complex, difficult business, not just a vehicle to gain political advantage or vent free-floating anger. We need adults from both sides of the aisle - in and out of government - to take on the challenge, cool the rhetoric and give us straight, plain talk.

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