What Overlap??

In the past couple of days there has been some back and forth banter between the President and the Republican leadership on the Hill about Healthcare, started when the President announced his intention to meet with the Republicans on Healthcare Reform (to the surprise of a considerable number of Hill Democrats, apparently!).

After the meeting today, the President declared his intent to develop a bi-partisan solution. He said:

“…Let’s put the best ideas on the table.  My hope is that we can find enough overlap that we can say, “This is the right way to move forward, even if I don’t get every single thing that I want.”….”

This is the essence of the problem for two reasons:

  • First, it exposes the notion that politicians believe the best way to craft a law is to trade some of your ideas with some of theirs and smash them all together.  I can envision their view of perfection: “OK, we’ll take out the death panels on pages 201-205 if you’ll accept the genetic testing and chip implantation found on pages 1,890-1,894.”

The problem is, a health care system, like any system has to have a consistent design.  Imagine those same two groups getting together to make a pot luck supper, with the Democrats bringing Tuna Noodle Casserole and the Republicans bringing Angel Food Cake.  Both recipes “overlap” with eggs, milk and flour (in differing amounts..but stay with me here).  Let’s play their game and combine the ingredients of both plans –ta da — Tuna Noodle Angel Food Cake.  Sounds terrific!

  • Second, it makes the idea of compromise and settling for less than “I want” to be the best means of design.

While it’s true that all design and implementation requires some compromise, the elements of compromise have to be about common objectives or the compromises don’t work.  Both parties have to agree to the parameters which should be the primary design points, or this won’t work.  Design teams that build cars push the design elements of design, performance, handling and cost — but they all recognize that the goal is a car that has threshold values for each element that must be met.

In the case of Health Care, there is no agreement about those parameters between the various factions, and that is why there is no bill.  There is no overlap between ‘government run health insurance’ and ‘market reforms which develop affordable access.’  There is no overlap between ‘individual mandate’ and ‘you get to choose your health plan.’

If the President were truly serious about his insistence on a plan that ‘doesn’t add one dime to the deficit’ he would have abandoned support for the Democrats’ Bills’ at the start, as each does add to the deficit.  If he and the Democrats were serious about achieving ‘universal’ access, they would not be pushing plans that fall well short of that goal.

Because of this disconnect between his stated goals and the bills’ actual performance, the Republicans are actually on the right side of this debate.   They know that the public shares their impression of the disconnect between the image and reality of the two Healthcare bills, and they are right to demand a new start.  They are also right that this isn’t an issue of trading your 2 ideas for my 3 ideas and combining the result — in fact, that’s what we have in these 2,000+ page monstrosities in the House and Senate.

The President is also wrong to complain about delay — if it takes another 6 to 9 months to get it right, then we should do so.  He used the same logic to ensure we are on the right track in Afghanistan, and this issue is just as important to the nation.