The health care debate is quickly becoming an epic American tragedy. As a concept, the original idea was marvelous: "Affordable, quality health care for every American". That is a wish every American can understand.
The reality was never going to be as clean and easy as the speech made it sound. Health care in America is a business. There are lots of people who make lots of money preventing people from getting sick, helping people who are sick, and insuring people for when we do get sick. When there are lots of people making money at anything, they're never going to agree on everything. Even those three simple terms -- "affordable", "quality" and "every" -- are inherently at conflict. But we all got the concept.
It's not working out the way anyone conceived. Where our leaders are taking us is not marvelous. Unless the White House moves quickly and boldly in the next two weeks, the most likely outcome of next month's congressional debates will be a health care system that costs individuals more than ever and ends up putting more money into the hands of the very people that created the mess in the first place.
There are probably about a hundred people in this country who really understand how health care works. I'm guessing that right now half of them are trying to change the system and half of them are trying to keep it the same. Let's see if we can't get more of us to understand the basics so we can decide for ourselves which is the better direction.
In the next four posts, I'm going to do my best to explain what's going on in the way I know best: with simple pictures drawn on a napkin.
Actually, it's going to take four napkins. My colleague Tony Jones and I have been through piles of research and enough whiteboard markers to get an elephant stoned. I think we've come up with a clear and simple view of the essentials of the health care debate.
Without further ado, here's the first napkin. Let me know if it makes sense. (Or not.)
(Click here to view all slides as a PDF.)
Lately though, the "payer" (my insurance provider) has come between me and my doctor, telling both of us which treatments are okay and which are not. In fact, my insurance carrier has become the party that "rations" my health care.
When I'm sick, the "provider" side (doctors, hospitals, pharmaceutical companies, etc.) love me. They get to provide their products and services and they get paid. (Partially by me and partially by my insurance carrier.)
Since I'm the only one putting money into the system (either via taxes, premiums, or cash payments), health care is a zero-sum game: there's only so much money to go around. When one business is getting it, the other is not. Both sides like to get as much from me as they can, to the exclusion of the other.
As the two sides fight to squeeze more blood from the stone that is me, I get... well, squeezed. This is bankrupting me and in more and more cases (can you say "Detroit"?) my employer. (More on that when we get to napkin 4.)
As it surveyed the damage, the White House determined that most of the things that need to change immediately fall on the "insurance" side of the equation. (Universal coverage, no restrictions, lower premiums, insurance exchanges, etc.)