Letter to the Editor

By Roger Kostmayer

THE GOOD, THE BAD AND THE PERFECT

 

If your house is on fire you have no choice but to leave and build, buy or rent a new home. Even if the new place isn’t perfect, going back to the old isn’t an option.

 

Five decades ago Republican President Nixon and Democratic Senator Ted Kennedy agreed that America’s lack of a national health insurance system was unsustainable and a looming disaster. President Nixon proposed a good national health insurance solution, even more progressive than the Affordable Care Act (ACA), but Sen. Kennedy and the Democrats shot it down because, from their perspective, it was imperfect.

 

Later, Ted Kennedy said that decision was the biggest mistake of his senatorial career.

 

For both humane and economic reasons “Health” is the objective; good preventive and affordable “Health Care” is the vehicle designed to carry society to that objective; and guaranteed “Health Insurance” (with better benefits at lower cost due to the massive purchasing power of 300 million customers) is the actuarial device for pooling the risks.

 

The Bad- is the unsustainable pre- ACA system where: 50,000 unnecessary deaths each year are attributed to lack of health insurance, cost escalation is out of control, and US health results rank near the bottom.

 

The Perfect – In my judgement, would have been to gradually expand highly successful single payer medicare coverage for everyone. There’s no rational non-

political reason to inject higher costs and more confusion in the form of insurance companies.

 

The Good – All massive legislation, like the ACA, requires corrections, adjustments, improvements, and modifications during implementation. If every player (President, executive branch, Congress, the states and the private sector) focuses on making this benefit effective and efficient (instead of a political target) – it will be so.

 

Unlike Senator Kennedy, we must not make the idea of perfect the enemy of a good solution.

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