This week the MPCA book club read pages 105 through 138 of former Senator Tom Daschle’s book Critical: What We Can Do About The Health Care Crisis. MPCA Director of State Policy Doug Paterson provided this response:
Part 3 of Tom Daschle’s book is a reflection on why past efforts have failed; attempting to learn from history and attempting to lay groundwork for his next section that proposes a national body that will oversee and direct whatever policy direction our country goes with health care. His reflection concludes that more of the failure has been a result of process than agreement on policy. He argues that politicians have neither the expertise nor the inclination to truly address this complex issue. Because of the complexity and the massive effort by current stakeholders who benefit from America’s current structure (most of the current medical care infrastructure), politicians are unable to resist those forces or understand the implications of both the current and proposed systems.
The book gives examples of other issues we have faced in the past and in which expertise for the design and operation of a solution have been distanced from the political process, specifically the Base Realignment and Closure Commission (BRAC), the Food and Drug Administration (FDA) the Federal Reserve system and in England, the National Institute for Health and Clinical Excellence. Daschle makes a strong case for the need to insulate the solution from the political arena which he believes cannot provide such a solution.
I think Daschle makes a strong case. Having observed the political environment for several years, politicians who are unable to dedicate the time, develop the expertise, and resist the power of very wealthy self interests working to maintain the status quo cannot be entrusted to develop anything new and innovative. We must design a new process if we are to have success now, when we haven’t been able to in the past.
We must use the lessons learned from the past if we want a different outcome, which to date has been “failure”.