Andrew Sullivan on the Health Care Summit

Andrew Sullivan gives his take on the meaning of this week's health care summit in his weekly column in The Sunday Times.

The Democrats want to provide basic private insurance to the 40million or so working poor who don’t have it. The Republicans don’t want to. Both parties want to stop the cruelty of denying people access to health insurance because they have a pre-existing condition, but if you do only that, then the insurance companies will take a big hit and hike premiums even more, rendering even more people without insurance. So you have to have a way to get the companies to agree to this by giving them 40million more customers to outweigh the costs. Only the Obama plan does that. The Republicans have nothing.

I have to say I think this is a reasonable, sensible centrist bill whose flaw is that it doesn’t do enough to control costs. The trouble is no one knows how to do that without brutal rationing, but the bill does contain sensible pilot schemes to test out new models and it increases patient choice through healthcare exchanges. Among the most promising cost controls once envisaged: mandating that the elderly get to talk to their doctor about end-of-life decisions. Getting more people to agree in advance that they don’t want their lives extended a few days or hours at massive expense would free up resources for the young. But this was quashed by Sarah Palin’s hysteria about “death panels”.

By the way, that bit of demagoguery earned Palin the "2009 Lie of the Year" from non-partisan fact-check website Politifact.com. Thanks so much for that contribution to the debate, Sarah.

Sully's takeaway is that the bill will probably pass but may not due to the difficulty of making sweeping change built into our system of government. Frustrated majority parties tend to whine about this as some on the left are doing now. However, it ensures a strong coalition and stronger leadership for big change to occur which is not a bad thing.

--Ballard Burgher