We know they are here, we might wish they weren't. They have an economic impact, both positive and negative. We need to secure our borders at least against terrorism. We don't know who is here illegally, we don't know where they are, we don't know where they came from and it is virtually impossible to round them up and send them back. The solution was a comprehensive plan...which went nowhere.
The problem was very apparent. While a comprehensive plan should have something for everyone to love and therefore easily leap the legislative hurdles, the reality is that comprehensive plans offer something for everyone to hate. They are so complex that no one ever reads them and the debate devolves into sound-biting and scapegoating. Registration becomes punitive. A citizenship path becomes amnesty. Work visas become a criminalization. Language requirements become jingoism. In the end nothing happens.
Yet, the congress-critters can't resist comprehensive solutions or at least attempts at solutions. One possible reason is that within a comprehensive bill you can hide an awful lot of pork. You collect votes like Brer Rabbit collected adherents to the tar baby. Someone doesn't like the bill so you throw in a sweetener for their district. Inevitably comprehensive bills lumber along and either fail, as the immigration reform did, or get convuluted into incomprehensibility as the healthcare reform apparently will. Immigration followed the Hippocratic principle of "first do no harm" because it didn't pass. Healthcare will, to all appearances, violate the oath in spades.
If you've got good care, you'll see it screwed up. If you've got employer benefits, you'll see a huge tax increase. If you don't have care and depend upon emergency room visits, you'll find yourself with less access and more expense. If you're a doctor you may give up the profession. If you're in healthcare support such as insurance, pharmacy, or medical equipment you will see your paperwork go up and your profits erode.
Are there problems with healthcare in the US? Of course. Fourteen percent of Americans aren't covered, but that means that 86% ARE! Is our healthcare expensive? Yes, but the quality is better than most of the rest of the world. Is comprehensive legislation the answer? Absolutely not.
If you are deeply conflicted about possible outcomes of a major move, doesn't it make sense to approach things incrementally? Why are the legislators so reluctant to take a bit-by-bit approach?
Possible the two most productive and sensible steps toward improvement are tort reform to reduce requirements for exorbitant malpractice insurance for doctors and elimination of restrictions on interstate sale of medical insurance. Stop frivolous malpractice suits and outrageous lawsuit awards. Foster competition to provide quality insurance regardless of which state a company is headquartered in and which state a client resides in. These two small steps might represent a giant leap for healthcare reform.
Here is my comprehensive plan:
- Abandon comprehensive plans
- Identify single problems
- Correct those issues in brief legislation
- Read what you've proposed
- Listen to the public
- Restrict bills to single subjects
- Disallow riders or amendments which spend tax dollars unrelated to the bill
- Subject yourself to the laws you impose on citizens.
Now, isn't that simple?
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