Wednesday, February 24, 2010

Getting ready for the summit

I visited my third grader's school yesterday to see his class present projects on which they have been working. The kids did a great job. While there, I happened upon a dispute between two 9 year old boys. The upshot was: you started it; no, you did; no you did....you get the picture.

Tomorrow the President and leaders in Congress from both parties will talk about health reform. I have written why I think the Senate bill is a step in the right direction, which as much as anything else, gets the ball rolling and makes continued dealing with health care inevitable over the next decade. I wrote on Sunday the outlines of what a deal could plausibly look like between essentially the Senate bill and Republicans. Such a deal would also be strongly preferable to the status quo. I'd gladly take either.

Maybe tomorrow will simply be you started it, no you did, etc. My hope is that somehow the summit could focus clearly on the individual mandate. There is no example of a health system with even near universal coverage without some sort of a mandate. If the Republican party has changed its mind on this (several key Senators, such as Grassley, supported an individual mandate in this Congress, but now oppose it on freedom grounds) that distinction really needs to come out and be made clear.

It will take a mandate of some sort to move toward covering everyone for at least catastrophic cover. If the individual mandate is rejected on freedom grounds, that would seem to logically lead toward rejecting the notion that providers have to give care to the uninsured, also on freedom grounds (freedom to enjoy the fruits of their labor). I don't want to go that way, and am happy to trade the freedom loss implied by an individual mandate to move toward universal coverage. But, we need to decide and move ahead. I think a direct discussion of the pros and cons of the individual mandate would be useful for the country.

The dispute at my son's school was resolved, but it took a grown up intervening. Here's hoping some grown ups show up tomorrow.

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