If You Build It They Will Come

As I observe the debate on health care reform, and I do use the term debate loosely, there is a fascinating battle raging underneath the surface.

On the one hand we have avowed statists like the President, Speaker Pelosi, Majority Leader Harry Reid and many congressional democrats who favor what I call the Field of Dreams approach. The essence of this approach is if you build it they will come. Components include an entirely new Federal Bureacracy including a healhcare exchange to sell you the coverage you are required to buy from the public plan which was designed by a federal committee largely appointed by the President. Proponents of this approach know they cannot come right out and take a stand for single payer for many reasons;

1. The blue dogs would be savaged in future elections by seniors who lost the Medicare Advantage coverage they loved when the reimbursement was cut to fund the coverage for the uninsured.

2. The vanguard of the proletariat that is our present near supermajority does not believe the American people are smart enough to understand the intricate issues involved in health care reform like rationing. No  matter they will act for all us little people. It is why we elected them in their minds.

3. Demonizing the insurance companies, the HMO's ( a federal creation by the way) and the rich doctors is a proven tactic which tosses red meat to their base while diverting attention from the fact the government accounts for 60% of the health care spend today.

4. Incrementalism works and Medicare remains the sacred cow.

5. Polls show many Americans are satisfied with their own coverage and their own doctors and will resist overt change as congress is learning at the townhalls.

6. Someone might point out that universal coverage mandated by the states and controlled has not stopped medical inflation in workers compensation.

On the other hand we have voices speaking out for market solutions that are being shouted down as obstructionists, mere drones who articulate platitudes from Fox News or talk radio. No one is focused on what unites us as American's. We have only the extremes and no statesman. No one is looking at the root cause of the current crisis but is rather seeking to exploit the crisis for their own self interest.

One of the insurance companies I worked for years ago developed a fully integrated product to cover health care, workers compensation, short term disability, long term disability. If we build it they will come said the visionaries in marketing. Very few employers bought the product because they wanted the flexibility to replace vendors by product. They resisted also resisted having all their products with one vendor as a problem in one area would require them to move all products. Nothing was unbundled you see. An infamous story circulated at the company where an executive stood before senior management pleading for more money time until the market recognized the value and was chastised by the CFO; "You keep coming in hereselling the same dog food and the dog just won't eat that crap". He built it but they did not come. Obamacare reminds me of that dog food. And the dog still won't eat that crap.