Monday, August 3, 2009

How to *prepare* to fix the US health-care system.

Outlaw the private financing of political campaigns.

That's right, make it illegal to campaign for public office with private money of any kind, including the candidate's.

Run a direct-mail agency, a travel agency, some TV studios, a server farm (with a VOIP solution), and make it possible for candidates for public office to effectively communicate with the citizenry on the public dime.

Give them a campaign staff, house a central campaign office, make hotel-ing offices available around the country. Give them a budget to hire political technocrats like pollsters and opposition researchers at G-whatever wages, or at some contractor standard. Give them 6 weeks to run for the primary election, two weeks off, then four weeks to run for the general election.

They can still use volunteers for the same reasons they use them now. Warm bodies will become the true campaign currency. Dominant campaigns will become dominant because they have a lot of people willing to put shoulder to the wheel for the cause.

You know what else would happen? Politicians would be forced into being accountable because the only way they could campaign for re-election outside of the above parameters would be by actually doing their jobs. Gone would be the constant stream of self-congratulatory fund-raising speeches to small groups of people with an excess of money with which to purchase political influence, which is legal now because these same grifters have convinced us that spending money is what Madison meant by freedom of speech. This string of empty polemics is what is perceived to be the politician's position. The politician is free to say whatever works best, because they are never bound to see that any of this actually happens. They can campaign literally non-stop.

What if they had to actually get things done? What if the only way a politician could claim to support health care access is by actually producing health care access? What if a politician could only lay claim to fiscal responsibility by actually doing fiscally responsible things?

I'm not sure a person currently in office would still have that privilege following the next election.

Yes, I mean him, too.

So, this will have to be done before we can get health-care fixed. Right now, the insurance and pharmaco companies have Congress bought and paid for. The current health care system works really well for the insurance companies. They get to keep 30 cents of every dollar that you send them. It's working pretty well for the pharmaco's too. It's illegal for the government to negotiate price with them, and they are the biggest customer. Sweet.

So, it won't change. And people won't vote these people out of office because they keep getting told it is not their fault, it's the other guys fault, and they know how to fight them, and they will win if they can only get the support they need to accomplish such big things.

Or, on Sunday they'll tell you that God loves people who send money to the church, and he rewards their generosity with abundant wealth and health in THIS life, and then eternal bliss in the after-life.

Either way, just pay up and you're in, unless those awful evil people thwart us again and we'll need your support now more than ever if that happens. Dang, those people are so obstructionist!

Health-care reform is going to require a wholesale change in the way it is done, and we are going to need some time to ramp-up to the new system, because we don't have enough people to see everybody right now.

This reform will utterly destroy the health insurance industry, and it will cripple the pharmaco industry. Pharmaco research will return to the academy, where it belongs. Yes, we will cure fewer obscure forms of cancer, but we will have cheaper and better treatments for chronic diseases. We will give something up there.

It's not pretty, and this sausage is going to be particularly ugly when being made, but the other choice, what we have now, will lay economic waste to this country when your children are your age. We can't afford to give-away 21% of the money we spend of health care (the difference between administrative over-head in private vs. government-run programs). We need it all, and we need to control the remuneration collectively to optimize the allocation of resources, just like a public utility.

Yes, there are things best done this way. Not making cars, not designing software, not journalism, those are best done as we do them now. We're smart enough to know the difference.

But, it will take real people committed to really solving problems in power in order to make this happen. Those people see no way into public office that doesn't involve selling themselves like soap. We need to fix that first.