My Take On The Healthcare Debate

I wrote my column on it. I don't find the opposition to reform somehow illegitimate. There are many reasons to criticize the plans now congealing; and the end-result looks to me more and more like a simple extension of healthcare security to a lot of people without any real or strong mechanisms to curtail the soaring costs that are bankrupting the country and putting so much strain on US business. Of course, I belong in that 200909_toc archaic camp that believes it is the job of a liberal president to expand such coverage and the job of a conservative opposition to propose ways to afford it. Instead, the chairman of the GOP is making the Republican position on Medicare indistinguishable from the most cynical Democratic scare tactics, and complaining about any attempt to curtail costs. If you have to strip out of a bill a mere conversation with seniors about powers-of-attorney for end-of-life decisions, you are not interested in a serious conversation about curtailing healthcare costs.

I agree with most everything David Brooks has written on this subject. If we had a functional and serious conservative movement in this country - instead of a Poujadist mob of cynical know-nothings - we would be talking about the kind of questions David Goldhill discusses in the best single piece on the debate I have yet read - the cover-story in the current Atlantic. We'd be talking about re-thinking the insurance model for large parts of medical care, we'd be cutting subsidies for employers, we'd be empowering patients to seek better coverage with better value and providing the tools to help them make informed decisions. Instead, we're talking Hitler and Oligarhy and "taking the country back".

Anyway, my column is here. It's bullish on Obama, as I remain.

Ben Nelson tipped his hand in a way today that suggests what I think we'll end up with - which will be a huge step forward on the accessibility front, if not on costs. (But we can come back on costs, and must, in a broader context of fundamental fiscal reform). My view of the president remains what it was two years ago: We're still lucky to have this small voice of reason in this nutty time. And if he becomes the first Democratic president to initiate universal healthcare access in his first year, he will indeed be transformational on a core domestic question.

Hang in there, Mr President. I have a feeling that the forces that elected you are re-grouping now we know exactly how determined and incoherent the opponents of change on all fronts have become. Above all, remember the discipline you showed in your campaign. You won through a combination of persistence, strategy and a refusal to take the bait. Don't take the bait, Mr President. The degenerate right (a better one will come along in time) only knows Rovian cultural warfare. They want you to fight back on their terrain. Don't. Just move forward. Talk to the country as a serious president should - about the problems we face and the debate we need to have to confront them.