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Minnesota 2020 Journal: Healthcare Solutions Not Distractions

October 18, 2013 By John R. Van Hecke, Executive Director & Fellow

The goal is better, affordable healthcare. The Affordable Care Act steps in that direction. It’s a victory but not a triumph because this fight is far from over. When we focus on improving affordable healthcare outcomes, we strengthen families, communities, states and the nation. Health, happiness and productivity are inseparable. Conservative opponents of affordable healthcare aren’t quitting and going home just because they lost their most recent fight. That’s why the affordable healthcare fight must be fought daily.

The Congress did not drive our national economy car off a cliff. Late Wednesday night, the Senate and House passed legislation extending federal budgets and borrowing authority. While conservative policy hardliners, the folks who hate the Affordable Care Act so much that they’d burn the barn, groused openly about moderate leader betrayal, cooler heads prevailed. The siege ended. A bill passed into law.

Despite the theatrics, conservatives’ latest assault on Obamacare reveals a genuine philosophical divide, separating strongly divergent world views. Government, conservative policy advocates believe, should do as little as is necessary. People experience greater individual freedom and broader liberty without government’s omnipresent and ominously intrusive hand. Progressives, alternatively, see government as both an expression of collective desire for family and community stability and as a modest defense against the concentrated wealth’s power and authority.

This past week witnessed the collision of differing philosophies that each manifest as “don’t tell me what to do.” But, for extremely different reasons. The world may have nervously scratched its head as the federal policy showdown played out but Minnesotans seemed to treat the whole affair as an unpleasant but expectedly weird annual family gathering. Under the circumstances, I think that we’ve borne the whole thing with remarkable dignity.

It’s important, in the post-crisis analysis, to understand that conservative policy leaders don’t object to Obamacare, they object to public healthcare. It’s easy to explain away conservative objections as a partisan strategy demonizing President Obama. That may be the case for some but it misses the larger philosophical construct. Conservatives don’t believe that people should organize themselves, using their collective strength to overcome concentrated wealth’s advantage. If anything, they favor laws preserving and expanding wealth’s advantage. People of few and modest means must be prevented from using the one tool that levels the economic playing field, cooperation for collective gain. Consequently, Obamacare haters' hatred comes quickly into focus. They object to the principal as much, if not more than, the practice.

We find evidence in the absence of an alternative plan. It’s one thing to insist that a health insurance plan is failing; it’s quite another to offer a different plan that addresses public need and conservative goals. Here’s the problem: conservatives don’t have a plan, they only have objection. The closest thing that conservative policy leaders seem to have, after killing Obamacare, is reverting to previous public healthcare funding mechanism but at a lower budget point.

The old model, paying healthcare providers a fixed treatment fee, almost collapsed under its own rapidly growing cost weight. Smaller, lesser government conservatives would have us return to that but with considerably fewer public resources tasked to the need. Philanthropic support would, the argument continues, replace reduced government sources. Except, charity couldn’t possibly meet the need or the demand. This is why conservatives don’t offer an alternative to Obamacare.

Minnesota does many things well. The annual United Health Foundation 50-state health rankings report, America’s Health Rankings-2012, gives us a useful snapshot. We have strong high school graduation rates, a low prevalence of diabetes and a low cardiovascular disease death rate. On the other hand, we’re about as obese as the national average, we binge drink way too much and we’re spending significantly less money on public health than we were five years ago. We’ve also experienced a distressing jump, over a ten year period, of children living in poverty.

The good news coming from the current rankings report? We can address our problems, creating a healthier, sustainable Minnesota. The bad news? Improvements won’t come easily. They require long term investments, a major shift in public attitudes and emerging support services that make past efforts look quaint. But, unlike conservative public healthcare policy objection, addressing real problems creates real plans. Obesity, smoking and binge drinking are real phenomena with real solutions to reduce their incredible destructive impact on families and communities.

I strongly believe in incremental change leading to long term positive outcomes. Railing against Obamacare is a political strategy to preserve conservative control; it doesn’t make our lives better. Lowering obesity rates is the more difficult but immensely more rewarding challenge. Working an actual problem not only brings us together, it creates opportunity. Minnesota needs affordable healthcare, not further distraction.

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