01 May, 2008
What Gives?
Why is health care reform treated like it can only originate from the desk of the President? Congress ignores it in the media as if its not an issue they have control over....the opposite is true. Why don't members of Congress stop acting like they would be stepping on toes by bring it up and start suggesting their own proposals? Is it because there is pressure to let it be an election issue?
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A few things. First, if you look on Thomas.gov, you'll see that there are a lot of reform proposals originating in Congress. They're primarily incremental proposals as opposed to sweeping reforms -- maybe this is what you object to? For one thing, reform is extremely complicated, and the likelihood of a congressman and his staff coming up with a viable proposal while dealing with other issues is small (a president can devote more staff to something like this). My other point goes to the lack of public support for a change, despite general discontent with the current system. A recent NEJM piece details the fact that despite Americans' concern about health care as a major national problem, over 60% are happy with their own personal health care situation (according to Gallup polls). To make any changes to the health system, you create some losers who will lose (or think they will lose) what they currently have -- and I don't think that most congressmen are willing to lose the support of their constituency. This very issue was one part of the failure of Clinton's attempt at health reform: a majority of Americans thought they'd end up with less from the new plan (when a smaller percentage was actually going to end up with less coverage than they had). Until there are ideas for reform that are more appealing to Americans, I think it's easier to leave this as an election issue that can tap into long-standing concern without going into specific detail on how reform would actually work.
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