President Obama delivered the key message at today's health care summit - controlling costs is a moral responsibility as well as an economic necessity. He described our out-of-control health care costs as "one of the greatest threats not just to the well-being of our families and the prosperity of our businesses but to the very foundation of our economy."
By stating that health care costs lead to a bankruptcy every 30 seconds (!) and could make another 1.5 million families lose their homes by the end of the year he made clear the human toll out-of-control costs are taking.
Because he's speaking in the context of daily economic news that keeps getting worse I think the public is prepared to see health care costs as a societal cancer. This has to be the starting point of any serious engagement with health care reform.
House Republican leader John Boehner has indicated what the two prongs of pushback will be.
First, Boehner makes this ostensibly reasonable statement - "We believe families and their physicians should make decisions about what treatments are 'appropriate,' not government bureaucrats."
This may be a good sound bite, but it's dead wrong. There is no way to control costs without some form of management of the ways in which we use medical care. If we leave care decisions to each physician and each family we'll just continue on the same bankruptcy-every-30-seconds spiral. President Obama will soon have to start educating us about the anarchy of misuse, overuse and underuse created by leaving decisions to each physician and family.
The second sound bite missile Boehner will invoke is the spectre of rationing. President Obama will need all of his rhetorical skill to respond, because mere invocation of the word "rationing," like "Nazi," is intended to be a trump card conversation stopper.
I'm no politician, but my leaning would be to say something like this: "The only place where there are no limits is paradise. The opposite of 'rationing' is 'irrationality,' not 'unlimited access.' Those who try to sandbag health care reform by shouting 'rationing' prefer to set limits by shutting almost one in six Americans out of health insurance and bankrupting a family every 30 seconds."
What's being launched today is a struggle about values, not an intellectual exercise. We've been miseducated about health care for so long that the President will have to be a patient teacher, repeating the key lessons in slightly different form day after day.