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random rants about news, the law, healthcare law, economics and anything I find amusing

Brooks on Healthcare Reform

David Brooks recently added a couple editorials on health care reform.  While still remaining carefully agnostic on this issue, I enjoy the way he turns a phrase and his moderate to slightly right vantage.  In one of these editorials, he recommends to the President a recent Atlantic article (that I mentioned in an earlier post as necessary reading in this health care reform season).

From “The Obama Slide,” August 31, 2009

The administration…has joined itself at the hip to the liberal leadership in Congress… The result is the Obama slide…. The public has soured on Obama’s policy proposals. Driven by this geneneral anxiety, and by specific concerns, public opposition to health care reform is now steady and stable…Amazingly, some liberals are now lashing out at Obama Some now argue that the administration should just ignore the the ignorant masses and ram health care through using reconciliation…This would be suicidal. You can’t pass the most important domestic reform in a generation when the majority of voters think you are on the wrong path…The second liberal response has been to attack the budget director, Peter Orszag. It was a mistake to put cost control at the center of the health reform sales job, many now argue. The president shouldn’t worry about the deficit. Just pass the spending parts. But fiscal restraint is now the animating issue for moderate Americans. To take the looming $9 trillion in debt and balloon it further would be to enrage a giant part of the electorate…This is a country that has always been suspicious of centralized government. This is a country that has just lived through an economic trauma caused by excessive spending and debt. Most Americans still admire Obama and want him to succeed. But if he doesn’t proceed in a manner consistent with the spirit of the nation and the times, voters will find a way to stop him…  The president’s challenge now is to halt the slide. That doesn’t mean giving up his goals. It means he has to align his proposals to the values of the political center: fiscal responsibility, individual choice and decentralized authority.” via Op-Ed Columnist – The Obama Slide – NYTimes.com.

From “Let’s Get Fundamental,” September 3, 2009

If I were magically given an hour to help Barack Obama prepare for his health care speech next week, the first thing I’d do is ask him to read David Goldhill’s essay, “How American Health Care Killed My Father,” in the current issue of The Atlantic. That essay would lift Obama out of the distracting sideshows about this public plan or that cooperative option. It would remind him why he got into this issue in the first place.The essay is about the real problem: the insane incentives…Goldhill is especially good on the way the voracious health care system soaks up money that could go to education, the environment, economic development and a thousand other priorities. Health care, he writes, “simply keeps gobbling up national resources, seemingly without regard to other societal needs.” Then I’d ask Obama to go to the Brookings Institution Web site and read a report called “Bending the Curve: Effective Steps to Address Long-Term Health Care Spending Growth.” …This report also focuses on the key issue: perverse incentives. It’s got a series of proposals on how to restructure insurance markets, reorganize provider payments, change the way effectiveness-research findings are implemented and cap the employee tax deduction…If I had a magic hour with the president, I’d tell him he can shift back to the core issue: the perverse incentives that make this system such a mess. He can embrace proposals—like the Brookings proposals or, more comprehensively, the Wyden-Bennett bill — that address the structural problems instead of simply papering over them…There are many people telling him to go incremental. They’re telling him to just enlarge the current system a bit and pay for it by pounding down a few Medicare fees. But did Barack Obama really get elected so he could pass the Status Quo Sanctification and Extension Act?  This is not the time to get incremental. It’s the time to get fundamental. Reform the incentives. Make consumers accountable for spending. Make price information transparent. Reward health care, not health services. Do what you set out to do. Bring change.  via Op-Ed Columnist – Let’s Get Fundamental – NYTimes.com.

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