Health Care: The Devil We Know

Heard a pretty perceptive comment on NPR’s Diane Rehm show yesterday. She asked one panelist why it seemed that Obama and the Dems were having a hard time getting people behind health care reform, and the panelist said: “Polls show that anywhere from 75-85 percent of people are satisfied with their insurance and their health care. The Democrats do not have a clearly defined plan right now, and without a clear plan, you’re not going to convince many people to give up what they have.”

Makes sense. Reminds me of something a veteran Dallas sports talker used to say about horse racing: “Old Ugly will beat Old Nothing any day.”

The current health care system is definitely Old Ugly to a lot of people, but right now the reform plan is Old Nothing, and explaining Old Nothing  seems to defy even Obama’s rhetorical skill.

One other point relating to my recent entry on health care rationing: Of course we have a form of rationing in place right now, and of course any reformed system will have to employ some sort of rationing, for reasons stated there.  But the current system grew up slowly, organically  over more than half a century, and for all its inefficiencies and blindnesses, it’s the devil people know.

If a radically different or even slightly different system is put into place, its problems and blind spots and boggling complexity won’t gradually become apparent over decades;  all the flaws will be glaringly obvious from the start, not to mention how they’ll be distorted by those who would block any reform. That’s a hurdle the reformers will have to clear, and it’s not going to be easy.


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