There are many views being expressed in the health care debate currently alive in the US. It's hard to find someone who's not passionate about their viewpoint - and relatively entrenched in their positions.
I recently read Kyrsten Sinema's 'Unite & Conquer: How to Build Coalitions that Win and Last'. One of the key points she makes in the book is that in order to build support around an initiative, it is important to build agreement around what problem needs to be solved, and be flexible on how that problem can be solved.
This intuitive approach has clearly been missing from the debate. Everyone has strong views on 'single payer', 'public option', 'government-run', 'insurance company profits', and so on... These are mechanisms but in themselves solve nothing. Focusing the debate on these things makes for good political posturing but does little to address the real issues.
I watched Michael Moore's 'Sicko' yesterday. As always, well done, very moving, but also somewhat overdone. I felt he weakened his argument by painting such a rosy picture of the systems found in France or the UK for example. These systems are not nearly as perfect as he paints them (I've experienced both personally), although they are definitely better than what the US has today. And that's the point I think Moore should have pressed. For the money being spent on US health care today, we absolutely deserve a much better, fairer, more effective system.
Moore talks from the point of view of the people who need health care and who experience great hardships due to the way the system currently works. This is the story that should be at the core of the debate, not all these mechanisms and options and 'means to an end'. Health care is about real people, real suffering, real hardship.
President Obama - similar to Hillary Clinton 15+ years ago - I think was too quick to present a solution. His opportunity was to create alignment and momentum around the problem needing to be solved, then bringing together his strongest 'team of rivals' yet to come up with solutions that would 1) solve the problem and 2) have chance of becoming law.
I liked Moore's parallels to police and fire departments, schools, post offices, as public services we take completely for granted. But again they argue in favor of making the entire system public. The fact is that the US health care system is almost entirely private, and any lasting solution will need to build from that point. We can't put the entire health insurance industry out of business overnight for example, that wouldn't necessarily help and that is the type of talk that freaks out a big chunk of the population. Of course that doesn't mean we can't deem health care coverage of public utility and regulate it as such, with strong safeguards...
So let's try to refocus this debate. Let's agree on what really isn't working in the current system. Let's also agree on some fundamental principles, like everyone who needs health care has the right to receive it, regardless of ability to pay. Like the fact that having had health problems in the past is reason to be eligible for more help, not being denied coverage or service. Once we're aligned on what isn't working, and what success would look like in terms of end-user outcomes, it makes it easier to identify how to best solve for that.
That can include looking at what is already working in other parts of the world, but looking objectively. The French system is amazing and unrivaled from an end-user perspective, but it is a massive and quickly becoming unsustainable financial burden on the French economy.
In the end, US voters should demand no less than the best health care system in the world, as measured by its inclusive coverage, ease of access and affordability, best in class facilities and care, and ultimate success in improving the health and well being of all Americans, especially those who need it the most.
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