Comedy This Morning: "All these sick people -- it's so depressing" (Tom Tomorrow)

I'm extremely diffident about putting myself forward as a health care policy expert, but for all the clamor I continue hearing ("We must have a public option!" "A public option is socialism!"), Let me say again that I'm not getting much of a picture of what the people on either side are trying to do, beyond having a bill or not having a bill, depending on which side you're on. (The insurance companies, I suspect, are okay either way, as long as any bill is their kind of bill.)

My starting point, as I tried to explain last week by way of writing about Howard Dean's views, as expressed in his new book, Howard Dean's Prescription for REAL Healthcare Reform: How We Can Achieve Affordable Medical Care for Every American and Make Our Jobs Safer, and the interview that just appeared in Esquire, is what I see as two distinctly different propositions about American health care:

(1) Some 47 million Americans have no insurance coverage at all, and consequently at best uncertain access to the health care system. This is a shock and a disgrace, and something needs to be done about it.

(2) The American system of delivering and paying for health care is so disastrously inefficient that it not only provides inadequate care but is on the verge of bankrupting us. Not only our physical but our fiscal well-being demand that we do something about it.

Both of these propositions seem to me unimpeachably correct. Is there anyone reading this who disagrees with either? But they aren't at all the same proposition, and it's possible to devise a plan to "do something" about one which does little or nothing about the other.

Yes, the cost of the plan needs to be considered, and the form of the "public option" to be included, though it would be nice if Democrats would remember Drew Westen's warning of how offputting that phrase "public option" sounds to average Americans. But by and large, the things I'm hearing debated to death don't give me much feeling that it's health care "reform" we're engaged in, just some kind of health care "revision" that's going to be passed -- or not -- mainly for the sake of passing something. -- Ken

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