Why is this the one thing?


When the terrorist attacks of 9/11 hit the United States, and then suddenly we were plunged into war, first in Afghanistan and then in Iraq, I don’t remember anyone demanding that the wars be “deficit neutral.” No one talked about whether we could afford them. They were things we just had to do.

When George W. Bush proposed giving vast sums to rich people in the form of tax cuts, no one argued that it would be “deficit neutral.” Rather, it was argued that cutting taxes wouldn’t bring in less tax revenue at all, it would bring us more tax revenue, because the economy would grow so much faster. And besides, it was somehow terribly urgent, something we just had to do.

When the banks tottered and needed to be shored up with taxpayer money to the tune of nearly $1 trillion, there was no way to argue this would be “deficit neutral.” We might get the money back, we might not. Whether we could afford it was not the question, we just had to do it to save the banking system. Similarly, the “Stimulus Bill” was terribly urgent, and something we just had to do, whether we could afford it or not.

Then we come to health care reform, and suddenly, it seems, this is where we draw the line. The president says that health care reform must be “deficit neutral.” It can’t actually cost us anything in tax funds. And everyone nods sagely and argues over how to do this. Why?

Why is this the one thing that we can only do if we can prove ahead of time that it will not actually cost anything? Our current system costs us an estimated 44,000 lives and impoverishes millions of Americans every year, and causes untold suffering – why is this the one huge national problem that everyone agrees we can’t afford to solve?

With nearly 30 years’ experience, Joe Flower has emerged as a premier observer on the deep forces changing healthcare in the United States and around the world. As a healthcare speaker, writer, and consultant, he has explored the future of healthcare with clients ranging from the World Health Organization, the Global Business Network, and the U.K. National Health Service, to the majority of state hospital associations in the U.S. He has written for a number of healthcare publications including, the Healthcare Forum Journal, Physician Executive, and Wired Magazine. You can find more of Joe’swork at his website, www.imaginewhatif.com, where this post first appeared.

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