Tuesday, January 30, 2007

A Persistent Issue

“In his ’52 State of the Union address, Truman vowed ‘to bring the cost of modern medical care within the reach of all the people” while Nixon, 22 years later, promised ‘a new system that makes high-quality health care available to every American.’ Not to be outdone, Mr. Bush offered a dead-on-arrival proposal that ‘all our citizens have affordable and available health care.’”

Those words are taken from a Frank Rich column that appeared on the Op-Ed page of the Sunday, January 28, 2007 issue of the New York Times. Although health care was not the main subject of the column, it seems to me that Rich’s observation is worthy of note.

If a political issue can last for more than 50 years, something about it must be more complicated than is being recognized. Perhaps the wrong question is being asked. Or perhaps there are aspects of the issue that are being ignored.

As readers of this blog will know, I have opinions on that subject. I believe that what prevents us from getting to the issue raised by Truman, Nixon, and Bush (among others) is the lack of discipline and accountability in the delivery of health care. Costs are too high, safety and quality are not what they should be and we don’t know who is supposed to do something about it. Right now nobody is in charge at the local level and until that is fixed, not much else is going to happen.

Perhaps there are better explanations. I’d be delighted to receive suggestions.

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