For me, health care reform is about achieving:
- universality
- affordability
- quality care
I don't care how we get there. I just care about getting there.
Unfortunately, I feel like the debate about health care reform has lost sight of achieving these ends and has become a battle about the means by which we get there.
For many fellow progressives, it's: SINGLE-PAYER or FAIL! Only the government can be trusted to provide cheap, quality health care insurance.
For conservatives, it's: ALL GOVERNMENT = FAIL! In the Magic Hand of the Marketplace We Believe!
I do not believe that this comes down to an either/or situation. I may lose some progressive cred when I say that - although I very much support a public option and would be happy with a single payer system - I am not hostile to the private sector and believe that private insurance companies can make profits and still deliver quality, affordable health care. Therefore, if the private sector maintains a large portion of the U.S. health insurance market, I will not be despondent.
As Ezra Klein often points out, there are superior health care insurance systems in the world that use all private insurance providers, including Sweden, Netherlands, and Germany (yikes, socialist countries all!). Of course, these countries strongly regulate these companies. Klein suggests that the Gang of 10 agreement moves closer to the model of these countries, at least for that portion of our population that gets private insurance (For example, they require 90% of premiums to go to care.) However, we must remember that our system will never fully be like these countries because between Medicare, Medicaid, and now Medicare buy-in, a very large portion of our population will actually get single payer insurance.
Here's my point: we need to stop fetishizing the MEANS by which we achieve affordable, quality, universal health care and instead remain focused on achieving affordable, quality, universal health care, even if - GASP! - private companies may still be part of the mix. I will not judge whether this is a PROGRESSIVE FAIL! or a PROGESSIVE WIN! simply by whether there is greater government involvement and less private involvement. I will judge its success by whether it moves our country closer - however incremental for the moment - to a more equitable health care system. Right now, we are closer to affordable, quality, universal health care than we were a year ago. We may be even closer to affordable, quality, universal health care in a few more years. This is not the end of the process. It's just the beginning. Despite all the problems we face with special interest inertia, this is a bigger achievement than many of us want to see. I understand that many may feel let down by the manner in which we move toward affordable, quality, universal health care, but rather than disengage and lose faith in the system and the Democratic Party, we need to remain vigilant and monitor whether what has been enacted achieves affordable, quality, universal health care. Fetishize the ends, not the means.