This comes a bit late, but some of you may have missed David Leonhardt’s July 22nd piece in the New York Times. You need to read it. I’ve not come across a more concise explanation of the obstacles to health reform since my adviser, Jonathan Oberlander, told me the fundamental paradox of health care cost control: HCE = SEI (health care expenditures = someone else’s income).
The point, which Leonhardt makes painfully clear, is that neither you nor I have the weight (read: money) to make much of a difference in this debate. It doesn’t help that we are so insulated from much of the cost associated with the care we receive. It makes rising costs a less urgent concern. Once we feel the pinch, things have gotten quite out of hand. Then, while we might like to see cost control, those whose income it is are adamantly opposed to taking a cut in pay. And in fairness, wouldn’t you be too?
Those interests–think insurers and healthcare providers–are well-heeled, and that permits them to line the pockets of the men and women who hold leadership positions on key Congressional committees. There is no such thing as a free three martini lunch. Trust me, organized interests (i.e., lobbyists) get things done. Fortunately, there are interests aligned on both sides of the issue. But what about you and me? Are our interests being represented? Sure, we can call or write our representatives, and in large enough numbers they’ll take note. We might be members of organizations with a government affairs division that takes up “our” fight on Capitol Hill. Then again, we might not.
At the end of the day, no matter which side of health reform you’re on, you’re placing your trust in politicians, hoping that they’ll decide to do what you think is right. Maybe they will. But if I were you, I’d seriously consider hiring a lobbyist.