This American Health Care debate

As the national health care reform debate has unfolded this past year, we have occasionally tried to point our readers towards good sources for making sense of these complicated issues. This post from  the summer suggested some especially useful magazine articles, blogs, and books on health care reform, while this famous  flow chart (now updated) from tried to summarize the major health care proposals in three easy steps.  We’ve also looked specifically at the debate over comparative effectiveness research and the potential expansion of Medicaid coverage for uninsured low-income adults.

Earlier this month, the radio documentary program This American Life aired two full one-hour programs devoted entirely to health care reform. As usual, the programs were insightful, entertaining, and thought-provoking. The first program focused primarily on trying to understand the exorbitant cost of the American health care system, with segments that looked at the role that doctors, consumers, and insurance companies play in keeping costs rising, even while more, and more expensive, care does not ensure better health outcomes.  The second episode focused on health insurance, and included segments tracing the history of the American employer-based health insurance system and looking at why more competition between insurers may not lower health insurance costs.

Unlike much media coverage and political discourse about health care reform, these programs avoid easy generalizations and simple solutions (“Insurance companies are greedy!” “Patient responsibility!” Public option!” “Health savings accounts!” ). Instead, they provide important reminders of the complexity of the health care system and the enormity of the challenges we face in trying to improve the quality of care at manageable costs.  Perhaps the only certainty we can count on is that whatever the precise nature of health care reform we end up with, or don’t end up with, this year, debates about health care will be with us for decades to come.


Former Executive Director David Blatt joined OK Policy in 2008 and served as its Executive Director from 2010 to 2019. He previously served as Director of Public Policy for Community Action Project of Tulsa County and as a budget analyst for the Oklahoma State Senate. He has a Ph.D. in political science from Cornell University and a B.A. from the University of Alberta. David has been selected as Political Scientist of the Year by the Oklahoma Political Science Association, Local Social Justice Champion by the Dan Allen Center for Social Justice, and Public Citizen of the Year by the National Association of Social Workers.

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