Healthcare Reform: Why is the American conversation so difficult?

Generations discuss healthcare issues
    Why is this so difficult? Last week, five healthcare reform bills passed out of committee and members of Congress are girding for battle.

The fight might produce a reasonable healthcare bill that Obama will sign before the New Year. But it could also yield a 100% casualty rate, with no healthcare reform at all.

Why is healthcare so difficult in America? That was one of the questions addressed by a panel of healthcare and health-insurance experts gathered at the University of Michigan Gerald R. Ford School of Public Policy last Thursday.

One of the featured speakers, John Kingdon, offered four reasons why it’s so hard to reform healthcare. He’s emeritus professor of political science at the University of Michigan and author of one of my favorite books on political culture, “America the Unusual.” Here are his reasons:

1. It’s a very complicated issue. That may not sound very insightful, but it is when you consider that 1/6 of the U.S. economy is related to healthcare. It might take Atlas to move healthcare.


2. Our political institutions were intentionally designed to not work. The separation of powers, checks and balances, and other contrivances make change, reform, and revolution very hard to do. Even Atlas would be ensnared by these institutions.


3. There’s fierce interest group involvement. Many powerful players don’t want change.


4. American values get in the way of healthcare reform. In general, Americans don’t place much trust in government. We prefer much less government than the peoples of any other advanced democracy. And, we hate taxes.


What do you think of these reasons? Do you buy them? What would you add to the list?

It might surprise you to know that Kingdon (and others on the panel) think healthcare reform will happen, despite these four seemingly insurmountable obstacles. But that’s a post for later this week. Stay tuned and join the conversation!

(If you’d like to listen to the entire set of presentations, click here to reach the Ford School resource page that includes an audio link.)

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