Among the many implicit precepts directing health-care reform are the following:
(1) The employer-based system doesn't work, either to assure coverage or control cost.
(2) The employer-based system must be preserved.
(3) A strong public option would offer consumers lower premiums and attract a lot of customers.
(4) A strong public option cannot be included because private insurers cannot effectively compete with it.
(5) Among the worst economic distortions of the system is the fact that employers choose insurance for their employees, and thus employees don't really understand the cost of coverage.
(6) The exchange cannot initially be open to employees, and may never be opened to employees, because they might leave employer-based insurance in order to shop for their own policies more aggressively.
You can go on in this vein, of course. It's a bit of a problem.
Watching the current debate in Washington, it’s tempting to think of health care reform as something radical and new - an issue that could force a profound shift in national identity. But America has been through this already. More than 200 years prior to this year’s push for a new national health policy, Americans were already becoming incensed about how they paid for health care, and who got access to it.Health care in Colonial America looked nothing like what we’d consider medicine today, but the debates it triggered were similar. The danger of smallpox and the high cost of its prevention led to divisive questions about who should pay, whether everyone deserved equal access, and if responsibility lay at the feet of the individual, the state, or the nation. Epidemics forced the early republic to wrestle with the question of the federal government’s proper role in regulating the nation’s health.
Colonial leaders and ordinary people alike possessed a similar sense that a proper solution to these issues would determine the brightness and shape of America’s future. At times conflicts over public health threatened the social and political fabric of communities. Did these rowdy Colonials, with the aid of the Founding Fathers, solve these dilemmas? Hardly. But their observations, questions, and compromises offer a useful lesson for what we can expect as we find ourselves again with health care in the forefront of the national conversation.
The rest here.
Ms. White never mentioned to the others who slept in the park that she had been nominated for a Tony award when she performed, alongside Glenn Close, in “Barnum,” in 1980; nor did she ask about their pasts. Severely depressed, she was too proud to reach out to social services, and kept the extent of her problems from friends. “Most of them are barely getting by in their tiny apartments as it is,” she said. “People in New York, they need their patterns. You can’t interrupt them.”
To avoid the police, Ms. White usually alternated sleeping for an hour with walking for an hour, which is what she was doing when she ran into Officer David Taylor on Grove Street at 4 a.m. one day last fall. Officer Taylor had come to know Ms. White when he was patrolling the West Village. He admired her energy, and, off-duty, came to see her perform. He had never seen her looking like she did on Grove Street. “She is usually someone who lifts your energy if you’re feeling down,” he said. “That night she looked soulless. I was concerned for her — scared.”
Read the rest.
