Thursday, September 21, 2017

Ross Perot's approach is what we need to break the muddle over health care reform

Won't someone please inject some
facts and figures into the health care debate? 

The more the debate trudges on in Washington over health care reform, also known as the campaign to repeal Obamacare, the less I understand even the basic contours of the ruckus. 

So confused am I that I woke up this morning thinking about Ross Perot, the short and very wealthy Texan with a squeaky voice who ran for president in 1992 on the promise of bringing businesslike rigor to the perennially chaotic federal government. The "Straight Talk Express" Perot called his campaign and John McCain borrowed the phrase in his 2000 presidential run.

Perot went on television, on his own dime if I recall correctly, armed with colorful bar graphs, pie charts and other teaching aids, plus a short pointing stick, to buttress his arguments. 

Now, lookee here people.  
Perhaps at this baffling juncture in the health care debate we need Perot's didactic style of politics to bring together both parties and have them explain to the American people just what the heck is going on. Three years after his failed campaign Perot even wrote a little-noticed book on health care reform.  Maybe there's something in it we should reprise.  

These televised teach-ins could be conducted by Rep. Paul Ryan, or perhaps Sen. Rand Paul—both devout followers of Ayn Rand's catechism of minimalist government—or some other prominent Republican leader, and televised nationwide to probably a limited but curious and motivated segment of the American public. 

President Trump definitely would not be qualified—even Republicans would admit as much—because other than continually calling Obamacare a "dee-saster," he doesn't seem to have a clue about what's specifically wrong with the program or how to fix it. You're fired. 

Democrats would be expected to put on their own health care reform show too, presenters yet to be determined.   

My assumptions are that there is something seriously flawed with the U.S. medical system that cries for urgent attention: It's monstrously expensive, more so than comparably developed countries. Worse still, it leaves out millions of Americans (twenty, twenty-five million?) with no access to basic health care. Lots of money for not-so-great results. 

Sorry, Fox News, shunting sick but uninsured people to the nearest emergency room is not anyone's idea of cost-effective or rational health care. 

The cynic in me must confess that I, soon to be seventy years old, don't have a dog directly in this race. Basic Medicare, plus some add-ons, pretty much covers my health care expenses, and Stew and I have enough resources to cover other costs here in Mexico or back in the U.S.

Yet I cannot write off the plight of millions of mom-and-pop-and-three-kids American families squeaking by on minimum wage or thereabouts, and trying to find health insurance that won't kill them with high premiums or deductibles, or critical exclusions in coverage. That doesn't seem fair. 

So here is what I would like to know:

1. What exactly is wrong with Obamacare? Republicans talk about it as if it were some dreaded fungus about to eat America's brain. Obama being a Democrat and black, and an all-purpose voodoo doll for Republicans, hasn't made an objective debate any easier. 

Still, I don't honestly understand what's wrong, perhaps because I've never fully understood how it works. 

Obamacare's elimination of pre-existing conditions clauses sounds like a good idea, though I can appreciate how it exposes insurers to more risk and potential expenses. But that's what insurance pools and actuarial tables are for, no?

In fact, when we retired but were not old enough to qualify for Medicare, Stew and I took a stab at buying individual policies in the much-vaunted "free market" and what we found were not only sky-high premiums but explicit exclusions of anything that might actually afflict us. 

I had a retina operation: So insurance policies wouldn't cover anything related to my eyes. And so on to the point the policies didn't seem to cover much of anything other than getting run over by an eighteen-wheeler.

Obamacare is expensive alright, and someone has to pay for it. Obama tried to cover the cost by taxing the very rich and requiring individuals to buy health insurance or pay a penalty. Taxes of any kind, particularly on the wealthy, are a mortal sin for Republicans, but what else is there? I'm listening. 

Time for Ryan, McConnell or Rand to have their Ross Perot moment and pull out their pie charts—or maybe flashy PowerPoint presentations—and explain why Obamacare is the worst, followed by the better ideas they have to replace it. 

Or if they believe in leaving health care up to the push and pull of the free market, I'd like to hear how that's going to work too. We need specifics rather than sermonettes about the horrors of big government. 

Cost-containment in health care must be part of the discussion. How's that's going to happen without some sort of government intervention? I want to hear how we're going to manage the clash of insurance companies, drug companies, hospital chains and other special-interest icebergs out to protect their profit margins. 

In fact, we have scant details about a Republican grand vision for health care for America. We hear rumors about obscure and contradictory legislative maneuvers, and last-minute fixes taking place but without the benefit of open hearings or public debate. It sounds like bubble, bubble, toil and trouble rather than an honest plan.

Democrats should get their show together too. How do we control federal budget deficits while adding another hefty line item to the expense side? What is wrong with Obamacare and how do you propose to fix it? And what about all those lobbyists for the medical-industrial complex banging at your door? 

So far Democrats have adopted the old tactic of standing on the sidelines watching the Republicans shoot each other. Recent talk about a single-payer system also sounds like fodder for a college bull session over pizza and beer, not a realistic plan. 

Who would present the Democratic vision? Please, no Nancy Pelosi, Dick Schumer or, God forbid, Hillary Clinton. There's got to be a new player in the Democratic bullpen. Looking for new faces and ideas itself would be a healthy exercise for Democrats.

Ross? Nah. He's 87 years old and happy somewhere in Texas counting his money.

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