Monday, April 13, 2009

government reform vs. market reform - Canoeing Down the Reform River

A Little on the Left, A Little on the Right

Jerry Brown , former governor of California , one-time presidential candidate, once major of Oakland, and now attorney general for California, said it best.
“Politics is like canoeing You row a little on the left, You row a little on the right. And you stay in the middle. You wave to spectators on the left and right banks.”

On the Left Bank , The Media

It goes without saying that those in control of the executive and legislative branches of the federal government have the biggest public megaphone and can dominate the media outlets, particularly the nightly television news. The big media tends to lean left with few notable exceptions – talk radio and Fox News.

Canoeing and Writing about Reform

I try to canoe when writing about health reform. Canoeing-writing about reform delicately balances top-down control and equity versus bottom-up choice and opportunity. It’s a philosophical debate between government guaranteeing coverage and reducing coss , and conservatives lobbying for more market innovation and more consumer responsibility. It’s about government-backed health plans; it’s about private plans. It’s about progressive lobbyists pitted against health care industry lobbyists. It’s about order, tolerance, and respect for it people’s opinions. For government it’s dependency, regulation, mandates, and control. For market-types, its choice competition, accountability, and personal responsibility.

Canoeing Amongst the Media

Canoeing isn’t easy.

But I have my ways. I start by reading the New York Times to see what the left is thinking. Then I go to the Wall Street Journal to get the view from the right. I look at a few left leaning blogs, like The Health Care Blog, and medical journal, the New England Journal of Medicine, which can counted on for left center opinions, always in perspective, of course, but always coming down on the left side of the argument.

Conservative Canoeing

Then I lean to right by visiting the websites of the Galen Institute, the National Center for Policy Analysis, the Center for Health Care Choices, and Conservatives for Patients Rights, aptly abbreviated CPR.. I may go to a couple of health care business canoe sites like Fiercehealthcare.com and healthleadersmedia.com., which profess to be neutral, but are skewed slightly to the right because they report the business news of health care.

Real Clear Political Canoeing

Finally, I generally settle in by looking at www.realclearpolitics.com, a daily digest of national politics. I like it because each day it contains 20 or so in-depth articles and editorials from left and right publications from left and right individuals.

You get a sense of the political sentiments of Real Clear Politics from a poll it runs among its readers, which today runs as follows

• Approve of Obama, 60%, Disaaprove, 30%
• Approve of Congress, 33%, Disapparove 58%
• Generic Mix of Readers, 43% Democrats, 42% Republics
• Direction of country, Right 32%, Wrong 61%

In Real Clear Politics, you’ll often run across pieces by Paul Krugman, to the left of President Obama, and Rush Limbaugh, to the right of Atilla the Hun. Lefty Robert Reich, former Clinton cabinet member, weighs in, as well as other current Democratic stalwarts, and you will often find articles by the likes of conservatively-oriented Dick Morris, Victor Hansen, and Charles Krauthammer.

Where’s The Reform Canoe Now?

Right now, my sense is the canoe is tilted to the left, but not so far as you might think. What the left secretly hopes for a tightly regulated insurance exchange for those without group coverage, a new public plan to compete with private plans , and mandates that force employers to cover employees and plans to cover all regardless of pre-existing illnesses. But as the reform debate approaches, the left is thinking smaller, seeking less, and fearing failure. Meanwhile the right is engaged in a holding action, waiting and hoping that health savings accounts, which now have 20% of the private plan market, will ignite and dampen hopes for universal coverage.

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