Powers' Chicken and The Egg Problem
Madison Powers' eloquent essay from CQPolitics.com last Friday analyzes Obama's two-fold problem passing healthcare reform.
What Powers calls "decoupling" the two key arguments about cost containment and expanding access to healthcare, I call his "chicken and the egg problem". You say potato, I say potato.
Fundamentally we agree: if you siphon off issues of cost away from issues of access to care you will never resolve the problem. If you wait for the economy to improve such that it would be easier to afford an overhauled health system, the political capital that Obama has built will be eroded. Keeping all the cats herded will not be possible for very long, certainly not for as long as it will take for the economy to improve as much as it needs to. Convincing all the major insurance companies to stay in league with each other is hard enough.
Even if one of the two of these were possible, it might be enough to keep the coalition together--but only for a short while. Healthcare reform simply cannot wait for either side of the equation to be entirely satisfied. Economic indicators will not improve dramatically in time nor will every stakeholder be aligned. But we all will have to take that leap of faith, or we will all drown together under the weight of our sinking healthcare ship.
Summer Johnson, PhD
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