Saturday, September 12, 2009

How I would prefer this health plan thing was done

I have said to lots of people that I support a public health care option of some sort. I am not too particular about its shape, so long as there is an insurance net that protects people who cannot afford health insurance. I also favor overall health care reform that gets costs under control and prevents the case where people's lives can be utterly destroyed by one massive medical bill.

But that doesn't mean I like how things are going in the current health care proposal - and my discontent is aimed at Democrats, Republicans and Mr. Obama. Here is my breakdown of things that I wish we would change.

1. Lose the antagonism
I agree with Obama's statement that the time for bickering is over. I wish that people would stop playing party wars and just work on the problem at hand.
I was quite upset, then, when in the middle of the speech Obama pulled out the "we said/you said" guns. He ripped at the Republicans for trying to privatize Medicare. He ripped at congress people, senators and a governor for promoting the death panel argument. He ripped at the previous administration for its spending practices.
And in the same speech he tries to position himself as the father figure coming in to tell the troops to behave. You lose a lot credibility on that stance when you immediately afterward: 1> pick a side, 2> start throwing the same tomatos.
I assume it is Obama's inner litigator getting the better of him. I get it - I do the same thing. When someone throws a line of bullcrap at you, bury them. In some venues it is almost a moral obligation to demonstrate that you don't take that sort of crap. In some venues.
The venue where it does not work is the one where you need the other guy to help solve the problem. If you just finished telling them they are liars, connivers, plotters and schemers (even if it is true) and then jump in and hurl jabs back, then you are going to lose them. It doesn't matter how reasonable your points are because you didn't lose on rationality. You lost by pure alienation and insult.
The President should have legitimately risen above the fray. Yes, he should have acknowledged the opposition, the attacks - but only so much as to give context to explain the counter argument. He should have ignored the insults like a bear ignoring bees. He should have focused more on laying out the mechanics of the plan, the options on the table and the means to solve the impasse so that the people in the room would be able to get to work. He should have left nobody any room to cry "foul" for him taking a partisan stance. I wish that had happened.

2. Lose the timeline urgency
I do not buy the argument that we need a full-packaged solution in place now. Human kind has lived for millenia with dreadful healthcare. Our healthcare has only reached humane proportions in the last century at best. The species knows how to continue its existence with misery, suffering and pain. I want a solution, but I would rather work on it slowly and get it right than rush it in. I believe rushing it in and getting it wrong will have worse impact than if we had not done it at all.
I am very cynical about the reason for the urgency. I believe the real reason for the urgency is because nobody wants "I voted yes on public health care" on the minds of the voters come next election. I suspect Obama knows this, and knows he won't get nearly as much participation from Democrat candidates if this goes on longer. They want this over and done with so they can put something else in recent memory to talk to their voters about. If this thing is all they have they are doomed at the polls and they know it.
This really makes me upset, because I believe we are going to lose the possibility of getting anything because of the rush. I want this to slow down. I want us to take longer thinking about how it should be done. I want us to... well... read the next section

3. Break the monolith into miniliths
Fixing health care actually has support from both sides. Disagreement is on exactly what to do and exactly what needs fixing. Maybe I think the wrong way for Congress, but that to me sounds like the type of thing you break into multiple bills which you vote on separately. Just a layman look, I would propose a couple: 1> health care insurance policy reform bill: this would cover all the "no pre-existing condition clause, no maximum lifetime cap... etc" stuff, 2> health care cost control reform bill: okay, I have no ideas on this, but the current bill seems to be rolling a bunch of stuff into it that proposes to reduce costs - so let's put those together, 3> public health care coverage bill: this is the one everyone is pissing in the wind about, so let's isolate it and have the vote on it so that it doesn't do collateral damage to other stuff people actually want...
Something like that. I am sure there are smarter ways.
I hear a lot of "If you don't keep clause , this all comes crashing down! You have to do !!!" I don't do economics, but I have been doing software testing for almost twenty years now, and I always cry "bullshit" on that. I hear it every time - some person become passionately enamored with a feature, and once they hear it is going to be cut declare the entire product unshippable without it. They have amazingly sound arguments... so compelling. Well, I have seen many features cut on a product line that makes billions of dollars a year... and I have seen many "critical" features kept (at high cost with added bugginess) that didn't matter two ounces to the customer. I suspect strongly the same thing goes with different aspects of any legislation - health care proposal included.
What I have learned from shipping software, though, is that you have to ship SOMETHING. Shipping late is bad, but not as bad as never shipping, and not nearly as bad as shipping something so dreadful and improperly built that you cannot sell or support it. It is better to cut in order to save the product. Yes, cutting is a risk - but let's remember what we are trying to accomplish here and not get so tied to our individual fixations.
And that is my proposal on the health care bill. One giant monolith, it is likely to die. Cut into pieces, the individual chunks may make it through. You also take the heat and controversy off the whole item - which means that you are far more likely to get comprose and less partisan bickering once people see parts of the problem they can actually work with.

Maybe I am naive, but I actually believe that if antagonism is dropped, the urgency removed, the timeline relaxed and the problem broken up into more workable chunks we would see both sides actually working on this issue in healthy debate. I wish Obama had seized the opportunity to work this way.

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