Sustainable Democracy

From the very beginning of these Presidential Primary campaigns, two issues have clearly stood out as the central themes shaping the debate; the Iraq war and health care. How the former develops will depend very much on the course of events in that country over the next twelve months. The later, however, is a much more knowable commodity. Health care has been the proverbial elephant in the room for American politics for decades now; just recently shedding its “third rail” status and moving into the forefront of the American political arena.

So while its impossible to predict how the Iraq issue will play out if security conditions continue to improve, the problems facing our health care system have been well hashed out for awhile now. These well-worn issues don’t look to change very much between now and November 2008, and so it’s much easier to see how the battle lines will be drawn.

That’s far from a hopeful prospect. The points of contention will no doubt be the same ones that derailed the last health care reform effort in the early nineties; a political disaster of such magnitude that no politician has been willing to tackle the subject since.

A study of that failure is helpful in illustrating the reasons our system has been allowed to deteriorate. Partisan mud-slinging and wanton fear mongering on both sides killed any chance of a sensible compromise and led to the abandonment of the plan altogether. Cynical politicians; Newt Gingrich springs to mind, were so set on preventing any plan that made any concession to the opposition from reaching fruition that they scuttled all hope of resolving the dilemma.

While the strengths, weaknesses, and ongoing trends of our health care system are well documented, no other issue has been more mis-represented and politically divisive. As the battle between the Clinton white house and the republican controlled congress illustrates, stark lines have been drawn between those in favor of a government-run health solution and a market based one. Because of this sharp divide and general unwillingness to compromise, the problem has lain unresolved for years, growing untreated like a malignant cancer.

The main problem is that voters and politicians alike tend to see health care as a metaphor for political philosophy in general. It has become more than a common sense, nuts and bolts issue; moving beyond simple economics and into the realm of “us versus them”. Either you’re a “socialist” who wants the government to take over every aspect of our lives; or you’re “in the pockets of special interests”, blatantly putting the well-being of huge insurance companies over that of the average citizen.

This sort of rhetoric, while popular with hard-liners on each side, is counter-productive. While members of congress are busy blasting accusations at each other from both sides of the aisle, medicare and medicaid descend deeper into financial crisis every day.

Medicare and Medicaid, our governments two largest entitlement programs, suffer from ballooning costs and wide-spread inefficiency. The cost of health care in general is spiraling out of control, forcing more and more Americans to forgo medical treatment altogether. The burden of medical coverage is crushing American citizens and businesses, causing many employers to abandon the practice of offering health insurance to their employees.

Clearly, something must be done. The country cannot afford another failed attempt to fix our sick medical system. Tackling this issue and finding a common solution will require leadership and compromise on both sides of the debate. Otherwise, we’re doomed to watch as Washington tears itself apart trying to score political points, while average citizens struggle more every day to simply pay their medical costs.