A Forum for Discussion on Health Care Reform: Cont'd

An Economist's Point of View


In continuing the discussion on heath care reform we have some thoughts from a former economist with the World Bank:

As an outsider, there are several ways to look at the issue: 1. Discussing technicalities, namely the tools to implement the president's option, including its costs and benefits; 2. To focus on the fundamental policy synthesized by the slogan "No one left behind", which contains two elements (a) affirmation of a social justice pursuit, and (b) depicting the society as a moving system with the implicit assumption that it is forging ahead (But, logically, there is also the possibility that the movement is backwards); 3 the political battle that pits the president against competing commercial interests (e.g. insurance companies and their adjuncts) and a medical profession with diverse views but essentially leaning toward opposition (Right?).

At all levels, it seems that the fight involves heavy lobby work, congressional influences, media intervention and (from my generic point of observation) is conducted mostly with the use of code words (such as socialism) or just buzz words that push the issues under discussion into the quagmire of stereotypes about class (poor), ideology (looser in the "survival of the fittest") and political issue (immigrants).

Of the three aspects, the third is the most interesting for the external observers. Will a very popular president, seen as an exceptional person worldwide, be beaten by parochial sectoral interests? Will a policy be rejected even after having been streamlined to a simple "option", an option further cast in basic terms?

The jury is still out, out perhaps in the streets of Washington. I am convinced that a lot of insight may be drawn from the outcome, well beyond the immediate issue of health insurance. It will be interesting to see.



Vittorio