Democrats can claim a victory in the health care arena. I just question which battle they won. The party’s leaders consistently touted broad, system-wide reform for nine months following the 2008 elections, but political rhetoric shifted after the swift-boating and town hall meetings in August. “Insurance overhaul” replaced “health reform” as the Democratic battle cry in September. The semantic switch occurred with such speed and consistency that it was surely orchestrated by skilled political advisers.
It was not a case of journalists seeking another word because reform was becoming hackneyed. Reform and overhaul are not synonyms. I think the difference is significant, and it needs to be understood to put the new law in context. According to my dictionary, Merriam-Webster’s 11th Collegiate, reform is the act of improving something by changing its form or removing its faults and abuses. It’s a radical challenge to the established order. Initial discussions of a health reform law adhered to this transformative meaning. Conversely, overhaul means to renovate or remake. It restores an existing structure rather than creating a new one. It’s non-threatening.
Overhaul is something done to a classic car, like a ’57 Chevy or a ’64 Mustang. These were great vehicles in their day. However, a restored old car is still an old car. An overhauled classic may look as beautiful as it did 50 years ago, but it gets lousy gas mileage, isn’t designed for safety, won’t fit in most parking spaces, and makes no sense for everyday transportation in 2010.
Transportation, on the other hand, is being reformed. The unstaged, untouched photo below illustrates the point. The SUV in the background is an overhauled version of the classic car: poor mileage, hard to park, expensive, etc. The mini-car and the motorcycle in front of it symbolize transportation reform in the true sense of the word. They are efficient and effective vehicles for getting around on today’s overcrowded roads. You can rent an SUV for the occasional trip that requires something big, but the smaller vehicles represent real progress.
From my point of view, the new law represents nothing more than an overhaul of the old health care system with all its problems. I can’t fault the political leaders who created it. They openly abandoned reform six months ago and delivered as promised. However, I am deeply disappointed that the newly legislated overhaul does so little to create health care equivalents of vehicles attuned to today’s different needs and limited resources. I am confident that our industry’s forward-looking providers, payers, and purchasers will form partnerships to reform health care. I just hope that the overhaul law doesn’t get in their way. What do you think? Does the new law take us where you want to go?
Photo by Jeff Bauer, ©2010
2 comments:
The best thing that can be said is that in spirit, this law will make insurance coverage possible for all Americans. That is noble.
Granted that the real work of cutting costs and accomplishing a system redesign were left unfinished, maybe this is not such a bad order of steps. And maybe it's not so bad that we have at least some form of universal coverage.
Never underestimate the government's ability to prevent the ability of those with the knowledge gained from actual work in the subject area to make the necessary changes.
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