Why This Time Is Different

Written by: Healthcare Advisor's Blog on Mar 23, 2009 10:49 AM EDT

David Cutler, Professor

Harvard University
Cambridge, Massachusetts

Health care is on everyone's mind, from families at the dinner table to CEOs in their corporate boardrooms to government accountants. Health care reform is essential to each of them. For families, health coverage can be the difference between solvency and bankruptcy, between life and death. For corporations, health care is a loadstone at a time when business has never been worse. For governments, health care crowds out all the other things they want to do. The path to fiscal reform starts with health reform.

Why, then, has health care reform been so elusive? The old folklore is apt: no one favors the current system over his or her ideal system, but the current system has always come in second place. The left likes single payer health care, and was willing to take 'no reform' over reform they didn't like. The right likes consumer choice, and doing nothing is preferable to what the left wants. Business had decided it would rather walk away than support a plan it wasn't sure it could live with. When people couldn't agree on their first choice, we were left with what we had.

But 'the old way' is slipping in popularity. By now, everyone realizes that something must be done. The major task is to ensure that we have a reasoned, rational discussion, so everyone can buy into it. Neither right nor left should be demonized; indeed, it's sometimes hard to tell the two apart on some issues. If we listen with respect, talk to each other and not past each other, and be prepared to face tough problems together, we can finally make reform the better thing to do. Decades of failure make me optimistic -- if we all decide we are in it together.

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