Right now in Washington, the most significant domestic reforms since the early 1970′s, if not since the 1930′s are being undertaken with a welter of proposals that are supposed to change our lives for the better. The Obama Administration has relied on Congress to come up with a number of different health reform proposals. From the point of view of the public, these are fast-moving targets which change on a daily and sometimes hourly basis as back-room deals are struck between various groups of Congressional representatives and the Administration.
I’m writing this blog to try to make a “map” of health care reform both for myself and for any readers who drop by. While occasionally you can read a particularly insightful analysis by a reporter or a pundit, in general these analyses get washed under in the tide of talk in the media about who is allied with whom and the details of the politics but not the policy of health care reform.
While we tend to find the conflicts and drama of politics more entertaining than the gray theory of policy, we who live outside the Beltway are actually affected more by the policy than the (relatively) colorful clash of personalities in Washington. This blog is an effort to highlight the relevant policy implications of what is going on and perhaps in a small way influence the debate on healthcare. My goals are ambitious:
- Define what health care is as an economic and social phenomenon
- Define differences between the delivery of health care and the promotion of public and individual health (a big one)
- Define what are principles of sound policy in the area of health care
- Support those policy proposals that recognize the reality of health care delivery and finance and are recognizable sound policy.
I guess I’m taking on some big issues here but I feel that current debates and policy proposals are taking swaths of the “terrain” of health care without having a reliable “map” of that terrain. I’m hoping at the end to provide readers with a way of evaluating what will no doubt be a complex set of laws and programs which may or may not serve to transform American health care for the better.
My personal belief is that we could in terms of the design of our health care system not do much worse than what we have now in terms of cost controls, payments, and revenue collection for that system. On the other hand Reform of some type is inevitable though we could go through a dark period of either stifled reform or reform based on misguided principles.
My interest in health care stems from a number of experiences and interests of mine which are not directly related to health care.
- I have a general interest in improving the quality of our social science, which I believe has failed us in a number of endeavors over the past decades.
- In an earlier part of my career, I have worked in health care delivery and research both funded by the government and funded by private funds.
- I have been a patient in the US and in Germany, which has a different health care system.
- I have a general professional interest in good policy, particularly in the area of energy and climate, where I see analogies with what is going on in health care. I am wondering if we are capable now of putting together any effective and thorough-going reform in any area of policy.
- I want to have good, secure health care for myself, my family and my friends that will not bust our or our nation’s budgets now and in the future.
With this introduction, I’ll start blogging… Enjoy!
