Either we will ration health care much more aggressively than we do now, or we will find much more efficient ways to provide health care. I vote for the latter, and I think most Americans agree.
This means that change, not stability has to be the number one goal of serious health care reform. This isn’t about propping up the current system for a few more years, or even about getting more people under the tent. It’s not even about ‘bending the cost curve’; it’s about whether the system will break down before today’s college students hit middle age. We have to learn to do health care in fundamentally new ways in the next twenty years. The changes needed are much more radical and sweeping than anything envisioned in the current legislation — and it will take a very different mindset to make them happen. The current bill is a classic example of steady state, blue social model thinking: it is more interested in keeping the status quo going by pumping more money into it than it is in the basic restructuring needed to build a system that will work in the future.