Even without crude politicking and deliberate distortion, fear threatens to paralyze the health care debate.
It's natural. But it's not productive.
A story in Friday's Daily News headlined "Elderly resist health reform" pointed out that many older Americans have little faith in the president's insistence that health care reform won't affect their Medicare benefits. Republicans have seized on their fear to intensify opposition to health care reform. Less partisan analysts say seniors may have legitimate concerns, given that the current health care proposal involves taking $500 billion from Medicare over 10 years.
This is a good example of why the health care debate is so hard. The issue is big, complicated and fluid. Health care strikes home for all of us, so the uncertainty inherent in this reform scares us right where we live.
But we can't let fear rule the work, because that way leads nowhere. Nowhere might be the political goal that foes of the Obama administration have for his presidency, but most Americans understand that we can and should build a better health care system that delivers more effective private and public care. Most Alaskans understand that, too -- just ask the state's Medicare patients who can't get in to see a doctor.
Reform proponents have a responsibility in this that's just as great as the opponents' responsibility to stop demonizing every suggested change. Proponents need to do a better job in explaining what they intend, how it will work, how we're going to pay for it and how reform will affect what people have now.
Proponents also should point out that defense of the status quo may be illusory -- even if you like the coverage you have now, there's no guarantee that deductibles, co-pays and premiums won't escalate, or that your employer won't be able to continue to offer good, affordable coverage, or that your insurer won't limit coverage or your provider won't restrict her practice.
Fact is, the status quo changes about every year for many of us. And the number of uninsured Americans is increasing, and that increases costs for everyone.
We should start with those things that most of us already agree on.
Examples:
• Pre-existing conditions shouldn't disqualify a person from health care insurance.
• We need more primary and preventive care providers -- and we need to pay for the up-front work that keeps people healthy and costs down.
• We need greater efficiencies throughout our health care system -- from swift access to accurate electronic records to more rational medical billing practices.
We may pause there, but we can't stop. Next will be the tougher questions -- how to extend health care coverage to more than 45 million Americans who go without, and how to control costs of care for all of us.
We're blessed in this country with an extraordinary quality of medical care. That's an encouraging foundation for reform. But millions of us don't have access to even the basics of health care, until that trip to the emergency room. And millions of others live in doubt about the extent of the coverage they do have, and the availability of doctors and nurses to provide it.
We can deal with this if we keep our heads on straight and leave the screamers on the fringe. The rest of us have work to do.
BOTTOM LINE: Running scared won't get us a better health care system. Steady, hard work will.