The .Plan

…as he picks up on the common historical theme: everyone and their mother has a plan for the health care morass. But when we can’t agree on a compromise plan, then we default to plan B: do nothing.

Our health-care morass is like the problems of global warming and the national debt—the kind of vast policy failure that is far easier to get into than to get out of. Americans say that they want leaders who will take on these problems. Large majorities profess support for fundamental change. Yet when it comes to specific solutions we balk. A big reason is the cost… Then we get bogged down in the innumerable, wearying complexities: whether abortions will be covered, whether states will be allowed to design their own systems, what’s an acceptable co-payment for drugs—and on and on…

If, in 2009, we actually swear in a President committed to universal health care, the fight will turn ugly…

People on the right will attack the plan as a tax-and-spend nightmare, because it will have to include some mixture of increases in business and personal-income taxes. And they’ll say that it dictates your medical choices and gives government too much control. People on the left—Moore included—will attack the plan as a boondoggle for insurance companies, because it isn’t single-payer, and will say that it gives government too little control. Others will attack it for what it does or doesn’t do about malpractice litigation, birth control, acupuncture, and so forth. The debate will become angry and murky and mind-numbingly complicated, and the temptation will be to put off reform yet again.
–Atul Gawande, “Sick and Twisted”, The New Yorker, July 23, 2007