Saturday, February 21, 2009

Health care reform on the horizon? Probably not.

Competitive marathoners like to say  that to win a marathon you  just need to run  20 miles and then race a 10K.   As if passing the most expensive legislation in history and wrestling with nationalizing banks weren't enough Obama is still just jogging that first 20 with a 6.2 mile sprint over health care reform looming.  Can it happen?  I doubt it but it should.

The nexus between employment and health care needs to be broken, the sooner the better. Ironically this would be a Republican issue if they were ready to lead in  the 21st century and not stuck trying to reinvent Reagan. Relieving health care costs for employers would unleash massive amounts of capital for reinvestment that would create waves of new jobs and growth, the kind of thing the GOP says it supports. Subsequent gains in tax revenue could offset much of the cost of socializing medicine. Would GM be teetering on the brink of oblivion if they were not spending over $5 billion annually  to cover current and past employees?  Of course not, but unfortunately  Republican boot-strap dogma clearly favors bankruptcy for GM over expansion of non-military governmental programs.  Obviously this isn't a winning issue long term for conservatives as rising health costs for US businesses will demand solutions and not ideology. 

In the short term GOP interests are going to be very well served by name calling.  Pinning the socialist label on a politician today carries about the same weight that labeling someone a witch did in Salem circa 1690.  With the very real possibility that BoA and Citi (at least) will be nationalized soon the socialist-hysteria buzz will grow even louder making it all the more difficult for reasoned voices of leadership to be heard over Joe The Plumber ranting.

That's  important because as this excellent article from the New Yorker points out the history of successful nationalized healthcare  worldwide has been largely dependent on the circumstance that triggered implementation.   Its a matter of nuts and bolts, not wonk.  Mismanagement killed Clinton's proposal and made it all too easy for the pot shots to blow holes in it.  If Obama doesn't control the political environment around the roll out of his plan then it'll suffer the same fate.

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