Health Care Solutions

Summer won’t be over for another two weekends, but you can feel the tone changing. The August news hole has been filled with what became an unscheduled reality show. News crews criss-crossed the nation in search of the most extreme voices and personalities showing up at town hall meetings to discuss health care reform.

It’s been a fun distraction, but September looms and things soon will get serious again.

What this summer has taught President Obama is that Medicare doesn’t fit America’s self-image. Health-care-as-entitlement invites doomsday calculations of the growing federal budget deficit, dark warnings of secret tax schemes, and unflattering comparisons with the French.

St. Vincent dePaul Executive Director Terry MacDonald told me once that he feared the need for comprehensive health care won’t be addressed in our society until we become accustomed to stepping over the sick and dying on our sidewalks. As long as the real need is hidden from our eyes, the ideal of the American can-do spirit blots out those among us who can’t-do.

A government solution has to appeal to our collective consciousness. The summer’s “Cash for Clunkers” frenzy shows how it’s done. Give a program a snappy title and get people to stand in line for it, and you know how the news will be told every evening, over and over. It’s a runaway hit! It’s a blockbuster! This fellow has been in line since 4 o’clock this morning, surviving with only his lawn chair, his Thermos, and his innermost drive for a good deal!

Comedian Jon Stewart reminded his viewers that cars are important to Americans, which is why the health and safety of every car in America must be insured. Unlike people.

Health care reform must begin with something people want. Health care is important, but jobs are what people want. As the unemployment rate inches toward double digits nationwide, people want the security — and the health care — that comes with a job. The system we currently use for delivering those benefits favors larger companies.

What if the government rewarded small business start-ups by subsidizing a health care benefit for each employee added to the payroll? Plenty of middle management talent has been idled by this recession. Many of them are pushing 50, and they feel it in their knees every day. They have good ideas that could become good businesses, but they fear the risks of a start-up.

The government could offer them a deal. Start a company that hires two employees and we’ll pay a third of your company’s health insurance expenses. Add four more employees and the government will pay half the health insurance for each.

The program would bring health insurance to people, but as a secondary benefit that comes with having a job. It will reward innovation and hard work, which we consider patriotic values. It becomes a very decentralized federal stimulus package.

If that idea won’t work, here’s another strategy for tapping the vein of American ingenuity.

Grant every state the federal Medicare and Medicaid exemptions Oregon and some other states have won, so each state can tinker to meet their own people’s health care needs. Remember we’re the United States of America. We can incubate ideas across the country.

We know we want the efficiencies that will come with a nationwide plan, so here’s a way to get each state to begin thinking big. Offer an X-Prize of $1 billion, to be given from the federal treasury to the state which comes up with the best plan by 2011 that can be extended nationwide.

The prize money will be awarded based on criteria formulated by a bipartisan commission. Their work will be to set the parameters, the rules of the game. But the game itself will be played at a very-local level.

If a state senator like Floyd Prozanski or a state representative like Jefferson Smith thought they could bring an extra billion dollars into the state’s coffers, they’d work on a plan evenings and weekends. And if that happens, I don’t believe there are enough anti-reform lobbyists and political operatives in the world to bother all of them.

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Don Kahle (fridays@dksez.com) owns a small media marketing management company in Eugene. He buys his own health insurance. He writes a weekly column for The Register-Guard and blogs, right here.