Archive for November, 2009

Vitality vs. Security? Not So

November 26, 2009

David Brooks gets it partly right in his recent column – the health reform debate is fundamentally about values – but he is wrong about the trade-offs.  His framing – “vitality or security” – sets up a straw man, a false choice.  How can anyone say that allowing 18-22,000 people to die each year due to lack of health insurance (according to the IOM and Urban Institute) represents “vitality”?  The tremendous loss of life as well as needless suffering and lost productivity in our current health system are surely a drag on our nation’s vitality.  And as Jon Cohn points out in his response to Brooks, the current employer-based system creates job lock for many people, stifling entrepreneurship and job mobility.

Of course, the Congressional health reform proposals could be stronger on cost containment, but they would be politically DOA.  The choice is simply between the status quo – with continued rising costs, rising uninsurance, inconsistent quality and more needless deaths – or an imperfect reform bill that expands coverage, reforms the insurance market, reduces mortality and suffering and establishes a framework for future cost containment initiatives.  It’s not about vitality vs. security – it’s slow death vs. possible cure.  Or in terms of values, it’s “we’re all in this together” vs. “you’re on your own”.