A very important debate is occurring at the national level over health care reform.  I must admit that I do not know as much as I should about the issues.  I, however, do have a few observations based on personal experience:

• Employer-Subsidized Health Coverage.  Am I the only person who thinks this is a crazy way to fund health care?  I believe this development dates back to World War II when wage controls prevented employers from increasing wages, so large companies began providing the benefit in lieu of wage increases.  If my understanding is correct, employer-subsidized health coverage is an accident of history, not a carefully thought-out policy decision.
• Free Agents.  The United States has significant numbers of independent contractors and small businesses for whom health coverage is difficult – or impossible – to fund.  Everyone from Daniel Pink (author of “Free Agent Nation”) to Tom Friedman (author of “The World is Flat”) is predicting that there will be more and more free agents in coming years.  It is not good public policy to have a system that doesn’t work for 45 million people.
• COBRA.  I would like to thank the people who championed the original COBRA legislation that makes health care coverage affordable (debatable, I know) for those who recently left employment.  Having said that, I am sitting here staring at my COBRA forms now, and I can’t even figure out how much I’m supposed to pay – and I’m a lawyer.
• Medicare.  I would like to heckle the people who came up with the idea that old people should have to choose from among various health care and prescription drug plans.  Many people my age have had to make these decisions for their bewildered parents.  It’s all well and good to preach the benefits of “choice,” but any system that confuses and worries the elderly is a bad system.
• Medicaid.  I appreciate the Medicaid safety net, but it’s unfortunate that people basically have to bankrupt themselves to benefit from it.
• Government-Sponsored Health Plan.  As I understand it, President Obama wants one of your options to be a government-sponsored health plan.  I don’t understand why so many people are up in arms over this proposal.  If the private sector can do it more competitively and efficiently, people will choose their plans.   As for me, I’ll probably bet on the government if I’m given a choice.
• Cost and Rationing.  I think government should ensure that somehow – someway everyone has the opportunity to acquire the basics of food, clothing, shelter, a certain level of education and a certain level of medical care.  Having said that, I think it’s reasonable for government to draw lines somewhere.  In the education arena, the line typically is drawn at post-secondary education.  I have no objection to the government saying that it will ensure that I receive a treatment that might lead me to live cancer-free, but not a very expensive treatment that, at best, will give me six more months to live.

The health care debate is complicated,  and I don’t pretend to know any answers, much less all of them.  But I am thankful that intelligent people are out there looking for reasonable solutions.  I don’t expect our leaders to come up the perfect system, but I do expect them to try.