"What’s the most important element missing from our national conversation about health care reform? I’ll boil it down to one word, governance.

Consider the story so far. We’ve known for decades that our health system is unsustainable; there is no question that it cannot continue on its present course. So Congress finally rounds up enough votes to pass the Patient Protection and Affordable Care Act and what happens? The debate starts over as if there’s a magic wand out there somewhere that will let us have everything we want in health care without any cost.

There is no magic wand. What’s more this whole discussion is a test of our ability to govern ourselves. How can we govern when we’re so divided over complex and philosophical questions? How can we govern ourselves when we don’t even agree on the basic facts?

Start with the general state of our health care system. The Center for Economic and Policy Research puts it this way: “The U.S. health care system is possibly the most inefficient in the world: We spend twice as much per person on health care as other advanced countries, but we have worse health outcomes, including a lower life expectancy. The government, through programs like Medicare and Medicaid, pays for approximately half of the country's health care, almost all of which is actually provided by the private sector. Thus, the bulk of our projected rising budget deficits are due to skyrocketing health care costs.”"

Get the Story:
As we talk about health care: Substitute “either, or” for “if … then” (Mark Trahant 7/19)

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