Views of the “Health Care Reform Summit”

This morning I ran into two contrasting views of President Obama’s “Health Care Reform Summit”. Jonathan Chait of the New Republic see the proposal as a great example of what he refers to as “the Obama Method”:

Obama uses a similar approach toward Republicans as foreign enemies like the Iranian regime: take them up on their claim to some shared goal (nuclear disarmament, health care reform), elide their preferred red herrings, engage them seriously, and then expose their disingenuousness…

while Bruce McQuain of QandO sees it as a somewhat different sort of political theater:

After months of behind closed door negotiations, it’s suddenly “sunshine” time. Why in the world wouldn’t Republicans be suspicious? It’s hard not to conclude (especially after the results of the televised meeting at the GOP retreat) that this is nothing but political theater designed to show the Republicans as “obstructionists” and the “party of no”.

What the televised “summit” will likely consist of is Obama and the Democrats pushing for acceptance of the same bill now pending and the Republicans saying “no”. The desired outcome is to have them say it right there in the open on TV.

Note that both seem to see it purely as a sort of political theater and that might well be the case.

However, I think that another explanation might be considered. Healthcare reform is a wicked problem. Three approaches to solving wicked problems include vesting the power to solve the problem in a very small number of hands (recruiting a “blue ribbon panel”), a competitive strategy in which those with differing views propose their own approaches. This allows the various approaches to be compared.

A third approach for dealing with wicked problems is the collaborative strategy, in which all stakeholders are engaged to find the best solution for each stakeholder in the hope that these solutions can be combined to produce the best solution for all stakeholders.

I think that something along the lines of the collaborative strategy may have been tried a year ago. Remember the announcements about representatives of insurance companies, pharmaceutical companies, physicians, and hospitals meeting and arriving at an agreeable solution? That sounds very much like the collaborative strategy. That some of the players may not have shown all of their cards or that the Congress wasn’t willing to play along goes some way to explain why that approach died so quickly.

The “Health Care Reform Summit” could be an attempt at employing the competitive strategy. It might just be a sincere attempt at identifying different approaches to reform which could be compared and evaluated.

There’s something about wicked problems that should be remembered. Sometimes the best you can do is bring the various parties together on an ongoing basis in the hope that new relationships could result in breaking the logjam or that something else may change.

IMO it’s very late in the game to start doing that. If you think that our fiscal problems are bad now, wait until you see what happens when as Medicare’s expenses grow beyond its revenues.