Health Care Reform: Trillion Dollar Spitballs


Here in the doldrums of August, the debate around Health Care Reform spins wildly as both sides position themselves against a Trillion dollar problem that is the key point of the Obama agenda. Basically, the debate comes down to two perspectives, as it always does.

On one side, the argument is made that the health care system is broke, primary care physicians make too much money from ad hoc testing, and insurance companies collect on the loot while millions of Americans go without the insurance needed to give them peace of mind in case of an accident, injury or just preventive healthcare.

On the other side of the debate, the argument is that the proposals on the table cost too much, put too much government in the middle of personal healthcare decisions and will hurt the businesses (and the GDP produced) by an artificial price ceiling on the healthcare business ecosystem. The argument from here, as well, is that we can’t rightly identify the problem that exists.

As a fiscal conservative, I tend toward the latter but as a social progressive, I can certainly see the points made by the other side.

In software development, there is a development paradigm called Agile development. In Agile, the idea is that the quickest way to get a product to market, gain valuable insight and feedback in real user test cases, and enhance the product delivery is with a fast, iterative approach. Get the product out there and people using it. Listen to them and identify the problems. As quickly as the product is released, start turning out updates on a very fast pace. Iterate. Iterate. Iterate. If you wait for the product to be “done” it will never be “done”.

The Agile approach to software development makes a lot of sense. You produce something, can very quickly get real life data, and adjust. The cost of investment and overhead are small and the footprint for total failure is reduced.

In the current Health Care Reform debate, it astounds me that both sides take an all or nothing approach. Either we throw trillion dollar spitballs and problems that no one can fully identify or wrap their heads around (individual input here is taken with a grain of salt since it is only one point of view from a limited scope of experience), or we do nothing at all, knowing that there is a problem even if we can’t identify it.

I think any startup will tell you that on the route to success, they had no idea where things would go. They may have only had a good idea that wasn’t vetted in their own minds and as they proceeded in building the product or the business, they encountered (and learned) along the way. This is the process that needs to occur. We can’t know everything right now, but we do know some things, and we do know there’s a problem.

Democrats need to stop trying to do it all right now while they have control of both houses of Congress and the White House. They are rushing things and that makes the whole deal failure prone. Republicans need to stop stonewalling and get something done. Yes, it’s going to cost money. Maybe a lot in the long run. But at the end of the day, there is an obligation of a society to take care of those who may not be able to take care of themseleves. With this in mind, iterate toward the perfect solution where society can do that, but let’s try to limit the costs and footprints and preserve the free market as well.

It won’t be perfect, but trillion dollar spitballs don’t solve anything.