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This is a picture of Aspen's health care panel, not pictured due to sloppy photography is Rep. Dianne DeGette (D-Colorado) who made some eloquent remarks about the failure of incremental reform in the congress. Incrementalism, she said, has been a "band-aid approach" which she then described (more like whack-a-mole) as simply causing new problems to appear in new areas in a way that makes structural problems worse. Under the circumstances, comprehensive reform is needed. What kind of reform? She didn't quite say other than that "everything must be on the table."

More to the point, her remark that what we need to do is "bring all the comprehensive and myriad interests in and begin to craft a package that will be portable, affordable, and universal" sums up why I'm not super-excited about the prospects for health care reform. After all, missing from the list of desiderata is improving public health. And I think that if we make our goal putting a package together that satisfies all the "comprehensive and myriad interests" then it's unlikely that we'll really get much in the way of improvement. Portable, affordable, and universal would be an improvement over the status quo but I think that even if it gets done people will wind up ultimately disappointed.

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