The Long View

It's Saturday. Maybe this is a good time to take the long view of the current healthcare debate.

The conservative revolution, which officially began in 1980 with Reagan's election, is now over. It accomplished many things, some of them good. After the bold experiments of Johnson's Great Society, a little reminder of the power of free-market capitalism was probably not a bad thing.

Over the two decades that conservatives tinkered with our government, their successes and failures became clear. Some areas of the economy thrived with a free-market boost, and others faltered.

It turns out that the free market was bad for healthcare. We kept loosening and loosening, giving the HMOs more and more rope. And guess what they did with it?

During GW Bush's presidency, there was a growing sense of frustration and desperation. These private HMOs were supposed to control costs and streamline delivery. We were supposed to have great care with lower costs.

But the opposite happened. Costs continued to spiral upward, and Americans were still denied care at unacceptable rates.

When your only tool is a hammer, you see nails everywhere. So GW Bush nailed healthcare --- with the free market. He did everything he could to promote private insurance, gave them subsidies, kept them from having to compete. All to promote the private insurance system. And what happened? Still millions of Americans without a doctor, and still sky-high costs.

Which is why today, a majority of Americans support a public health insurance option. We aren't idiots, and we've been paying attention.

So it's time to accept that the free market system just doesn't work in healthcare. I'm not saying this as an ideologue. I'm saying this after watching (and working within) the healthcare system during the 90s and 00s.

Plenty of free-marketeers have come to the same conclusion. Check out this article from Motley Fool, a well-known financial website. The people at Motley Fool are die-hard capitalists, and they argue that a public plan is actually the most capitalist choice.

It would have been nice if things had gotten better when we deregulated healthcare, like in the telecom industry. But they didn't. The opposite happened: costs rose, patients were still denied care, and frustration exploded.

So don't let anyone tell you that this is an ordinary liberal vs conservative debate, because it's not. This is not a battle of ideologies. This is a battle between people who are looking clear-eyed at the past twenty years of healthcare, and people who are clinging to ideology without looking at the world.