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Friday, June 19, 2009

Insisting on a Better Way

It is surely no coincidence that, during the past several weeks, when the healthcare reform effort has been reaching a critical point, the voices of opposition against the Obama administration's economic policies have grown increasingly shrill.

On the other hand, it is a pleasant coincidence that, as we near Father's Day, some of my primary illustrations of the theme of this post come from a couple of stories my father told me long ago.

The first story was about how my grandfather reacted when the first motion pictures with sound ever came out. People called them "Talkies," at least in the small New Hampshire town where Dad was born and raised, to distinguish them from the silent movies of the day. My grandfather, according to Dad, characterized Talkies as a fad that would never last.

Far be it from me to poke fun at my late grandfather for this. He was a man of his times. And a man of his environment.

That environment is illustrated vividly by the second of my father's stories that came to mind as I formulated this post. The town that was home to my father and grandfather was the same place where, at a town hall meeting, when the topic of improving the literacy of local students was being discussed, an elderly citizen stood up and said "I don't believe in readin'. Readin' rots the mind." This is of course a very narrow view by a more contemporary and cosmopolitan standard, but it was a view that represented a pattern of thinking that has not been uncommon in certain places and times.

Let's be grateful that there have always been people who, even if they're usually in the minority, have been more open and imaginative in their thinking -- people, in other words, who insisted that there must be a better way. What would cinema be today if everyone had shared my grandfather's opinion of Talkies? And what would our entire society, let alone our educational system, look like if everyone shared the opinion of the elderly gentleman at the town hall meeting?

How does this relate to the healthcare reform debate? Well, it hit home for me during the first hour of All Things Considered on NPR today. I heard a teaser on a story that, as I write, may not yet have even aired. It featured interviews with physicians from Howard County, Maryland, on the subject of healthcare costs.

In a brief sound bite, one of the docs was talking in plaintive tones about the countless hours that are wasted on such bureaucratic processes as filling out forms, verifying insurance coverage, and so on, implying that costs could be reduced drastically if only we could make better use of all the modern technologies and resources at our disposal to make the process of managing healthcare more efficient.

So far, our wonderful, privately managed, competitive healthcare system hasn't accomplished that efficiency.

The real question, when you cut through all the partisan rhetoric, and through the squeals of interest groups who feel that the government is about to take away the fat slice chocolate cake they've grown used to having after every meal, is "how can we find away to do this better?"

If we engage in "readin' rots the mind" or "Talkies are a fad" thinking, we get to the kind of rhetoric we're hearing now -- "ObamaCare will bankrupt the country and destroy the best healthcare system in the world"; or "the system is so hopelessly broken that there's no fixing it"; or "government is incapable of making anything better and more efficient"; or "we'll end up with the nightmare scenarios of endless waiting lists for surgeries, rationing, and denials of treatment that you see in Canada and the UK."

Behind all that rhetoric, basically, is the kind of "it can't be done" thinking that hinders progress. It's like saying, before television, that "it's impossible to send pictures through the air." And it also reminds me of something that was said by an old-school mainframe programmer who worked for an organization where I used to work. His opinion in the early stages of an effort to migrate our content management system from mainframes to PCs was that "it can't be done."

The destructiveness of this kind of thinking is self-evident. And perhaps, unfortunately, there may even be a trace of it in the approach of compromise that Congress and the administration feel they have had to adopt in conceding that single-payer is off the table. The administration, in other words, should perhaps be doing a better job at articulating the message of "there must be a better way" to deliver healthcare to U.S. citizens, and the message that, even though our current, flawed system may indeed be the best in the world, at least in terms of creating innovative treatments, it doesn't mean that it can't be made better.

There must be a better way. That's the message that President Kennedy so successfully conveyed to the people in rallying support for the effort to land a man on the moon. And perhaps that's the message that President Obama should be articulating on healthcare reform. What if there's a way to still allow doctors, health insurers, and other healthcare professionals to be reasonably compensated, and to insure all Americans and give them fair and equal access to the best available treatments, without the need to put the private healthcare industry out of business?

The simplistic rhetoric we're hearing is all of the "either, or" variety -- public OR private; capitalist OR socialist; free market OR government-run. But those who are squealing loudest are likely to be those who have the most to lose. It's the same pattern that occurs in the "not in my backyard" reaction to certain public service projects, or the "don't cut my pork-barrel project" reaction to government budget cuts.

But the real issues aren't about any of that. It's all about finding a better way, about insisting that there is a better way. We need "we're going to put a man on the moon in 10 years" thinking here, not "reading rots the mind" or "Talkies are a fad" thinking.

Are Congress and the administration compromising too much, or not thinking boldly enough? Perhaps at this stage the best we can hope for in the near term is a baby step of progress. But if that's the case, let's not take our eyes off the long-term aspiration for a better way.

I'm glad that my father, in spite of a tendency in his home town to look at things from a rather narrow perspective, was someone who realized that there must be a better way to live, and got himself an education and allowed his life to take on broader horizons, both geographically and intellectually, enabling me to have a life much richer in possibilities.

Let's take a lesson from that model and from everyone else who understands the value of insisting on a better way, and apply it to our thinking and decision making on healthcare reform, and to the feedback and criticism we provide to the elected officials who are currently engaging in the debate.

And Happy Father's Day, Dad. Sphere: Related Content

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