The Rudy Health Care "Solution"

Rudy Giuliani just announced his health care plan. It's not a winner. Of course, Rudy being Rudy, he couldn't just announce what his ideas are without any preparation. First, he had to warm up by spending a day or two imitating a wingnut talk radio host and calling the Democratic candidates "socialists" and who belong to a "party of losers" and are all "heading for France" (or, alternatively, "Cuba"). He also said that it's "unrealistic" to expect a system where "everyone is taken care of from cradle to grave."

The core of the Rudy plan is really nothing new. From the looks of things, he dusted off the President's "Better Healthcare Through Tax Cuts" plan. That was the non-starter from back in January, with the President proposing tax breaks for people who buy private health insurance. Rudy's added some things to it - like making it easier for the insurance industry to make money by providing health care plans that are completely inadequate:

Require Availability of Low-Cost Insurance Options: Regulation must not deny access to affordable coverage, and currently over 1,900 state mandates limit coverage options and increase costs from 20 to 45 percent. If a state's mandates prevent affordable health care coverage, citizens should be allowed to purchase coverage through interstate markets.

That's a dangerous idea. It's something that will make things look good on paper - more people will be able to buy coverage, so the number of uninsured will drop - but it's going cause a whole different problem. There will be fewer uninsured people, but there will be lots more underinsured - the lower cost plans will provide some coverage, but they are not going to be able to cover everything.

The health care situation in this country right now is not good. I think that's a statement that everyone can get behind. Lots of people can't afford to pay for insurance, and they can't afford to pay the bills when they get sick, either. Hospitals still have to treat those people (and they should have to treat those people), but in many cases they don't manage to recoup enough to cover the costs of treatment. They need to cover their costs, so the rest of us wind up paying more. There are problems with the medical tort system, and those problems do add to the costs. The defensive medicine that a lot of doctors practice to avoid suits can create problems. All of those things need to be fixed, and it's good that Mr. Giuliani at least recognizes that much.

The big problem with Rudy in this case isn't so much that he's got a health care plan that probably won't fix the problems. (That's a problem, to be sure, just not the biggie.) The problem with Rudy is the pure nastiness that he's been dishing out at his opponents. As someone who lived in New York City while he was mayor, I can tell you that the nastiness isn't a campaign strategy - it's who he is. And that's very, very bad.

The health care problem is very complex, and finding a workable solution is going to take a concerted effort by many intelligent, dedicated people coming at the problem from many different perspectives. I don't think the problems can possibly be solved unless people are able to sit down, look at each other's suggestions with open minds. It's entirely possible that solving the problem might actually require taking something from the suggestions on the left - like, for example, making sure that everyone is insured so that doctors and hospitals always get paid - and something else from the right - it might also be nice if OB's didn't have to pay 200,000 a year or more for liability coverage.

Namecalling is not going to get us any closer to a solution. If anything, it's going to poison the well. Rudy, unfortunately, seems to be physiologically incapable of maintaining the level of adult discourse that's needed.