Some smaht guy who writes here makes a good point on healthcare:
Amen. Universal coverage is the core goal. Doctrinaire folks can imagine the blank page on which we’d write the perfect system. In the real world, we have to confront-and reform-a system w. stakeholders, rent-seekers, and tons of sub-optimal equilibria. Eyes on the prize. https://t.co/6xGdVgkkSw
— Thomas Levenson (@TomLevenson) December 24, 2018
I am in full agreement with Tom. My priority on a personal and political level is universal coverage without too much concern for the actual mechanics of that coverage as long as those mechanics produce an outcome that creates affordable care at both the point of service and for society, some justice in the distribution of care and health, and continues to produce reasonably strong innovation incentives.
And all of those goals will require dealing with current stakeholders, rent-seekers, political roadblocks and non-optimal (locally or universally) equilibrium. It is going to be messy as an overtired and caffeinated toddler at a birthparty which has a build your own sundae as the main sweet.
To achieve that goal, a political coalition will need to cater to the marginal votes. To achieve that goal, a political coalition will need to make hard trade-offs. To achieve that goal, a political coalition will need to smooth off pain points at the cost of optimality (however that may be defined).
It will be messy politics as it is a core political question of who holds and how does power over life and the future function.