A second chance to get health care reform right

I was intrigued to read an op-ed in this morning's Oregonian which is very similar in basic outlook to my most recent discussion of medical reform.

The author, Ron Mock, is an associate professor of political science and peace studies at George Fox University here in Oregon. With kind permission from Prof. Mock, I am posting his piece here. As he notes, "We do make similar points about the process, with enough differences that we won't be redundant to one another. "

A second chance to get health care reform right

By Guest Columnist
January 25, 2010, 9:00AM

By Ron Mock

I voted for Barack Obama in 2008 and celebrated his win. I rooted for Scott Brown this year in Massachusetts and am celebrating his win, too, because Brown's victory gives Obama a second chance to be what he promised to be.

Barack Obama won my vote because he was idealistic and pragmatic and trans-partisan. I believed him when he said he was committed to addressing the big issues where we had allowed things to drift into dangerous territory because of the flaws in our old politics: overdependence on special interests and growing polarization.

I believed Obama when he said he would appeal to our most fundamental human values and our most important overarching goals. He would help us see where we all -- Republicans and Democrats, blacks and whites and others -- shared ideals and dreams. Then he would help us develop the creative new ideas that would allow us to work together to face the big issues, not sidestep them.

Obama as a candidate in 2008 said health care costs were growing at a rate that would bankrupt our country. People without insurance were being left out of the system. All attempts to reduce government deficits were doomed to fail if health care costs continued to mushroom. He told us we needed to change the dynamics so health care would be accessible to all while consuming less of our national wealth, rather than constantly consuming more.

I agreed with all this. To get health care cost containment and expanded health care coverage, we needed a president who recognized the urgency of the issue, would go all out to address it, and would be able to create a trans-partisan creative environment in which the best ideas of each political faction could become resources for a new solution.

So far, Obama has not lived up to my hopes or our needs when it comes to health care policy. He didn't come equipped with a rock-solid vision for a new system that would work. He didn't look very far for ideas. He left the initiative to congressional leaders with truncated partisan perspectives. He endorsed a flawed approach. And worst of all, instead of presiding over trans-partisan creativity, he sat by while tawdry backroom politics were used to sell off favors in exchange for votes.

The current Democratic plan is hardly the product of a reality-based process. Health care costs are skyrocketing because so many of us use insurance paid for by someone else to fund most of our health care. We practically ignore the true costs of our health care, even if we pay modest co-pays and deductibles, because the most important costs are covered for us. As a result, neither those who consume health care, nor those who produce it, have any natural incentive to curb costs.

We are playing with a law of nature here. If people making choices about consuming health care are insulated from the costs of their choices, they will consume more health care. The more they are insulated, the more they will consume. Insulate them entirely -- make health care free -- and there will be no effective limit to how much they will consume, unless that limit is provided by some outside force.

The Democrats' insurance reform proposal will make insurance available to more people, but in every other way it will reinforce the dynamics that are inflating costs -- unless government officials start limiting our access to the system. Costs will go up faster or access will be limited by agencies beholden to the political system (with all the attendant opportunities for incompetence, indolence, corruption and abuse), or both. Most likely both.

I oppose the Democratic health care plan because I'm certain it will make problems worse, not better. But I also think good health care reform is possible. I have seen ideas with elements that, when combined, could do much better than the current plan. Oregon Sen. Ron Wyden proposed some of them last year. Martin Feldstein proposed another approach last fall in which every American would get vouchers with which to purchase health care insurance, with a deductible scaled to income calibrated to make consumers pay attention to costs but still be manageable under most families' budgets.

These aren't perfect ideas. But now that Scott Brown has been elected to the Senate, Obama will need to recalibrate his approach. If he can learn from the botched first attempt, open lines to all points on the political spectrum, and start mining them for ideas and cultivating them for allies, he has all the intellectual and personal tools to pull off real health care reform this summer, or maybe in 2011 -- and in the process establish his credibility to tackle the even bigger issues (our stagnant economy, global warming, terrorism) that lurk just beyond health care.

Ron Mock is an associate professor of political science and peace studies at George Fox University in Newberg.