It's important for the general well-being of our nation that we work together on the problem of keeping the most number of citizens healthy for the longest amount of time possible in the most efficient way possible. That's easily said. But what can we do about it?  Watch and see what Congress will do; it will surprise you.

"We want to build upon what's best  about our current system, but we have to change a number of things in order to make it work for the future," said Sen. Olympia Snowe to John Harwood.

"I think the right policy will garner votes," she said.

Thank you for your constructive voice, Senator. But many Americans these days, on both ends of the political spectrum, have forsaken their faith in a Congress that can actually produce the "right policy."  Bahhumbug! to you skeptics who are ready to give up on the system because you think it is corrupt beyond repair. Sure, there is lobbying that dilutes the outcomes of proposed legislation.  And yes, vested interests do make money inappropriately off the process. What else is new in the history of the human race?

But this health care thing is different. You see, Congress is now under a public microscope, thanks to a citizenry that is fervently engaging in public discourse. If civil people (This means you!?) will get involved with the debate, the mayhem of upstart rabble-rousers will be drowned out by the voice of reason. This is how democracy is supposed to work. Senators and
Congressman will pressed, literally, by the voice of the people, into true responsibility.

The favorable difference in outcome in this case--the proposed health care Act of 2009--is that everybody is watching.  We have a situation here where the center can, and will, produce a finished legislative product  that is acceptable to the extremes of both parties. Sure, single-payer went down before this drama even started.  And the public option--well, it is evolving-- but its inspired emphasis on universal coverage is metamorphosing into a form that will pass effectively through this moment in time-- this unique window of opportunity.  Health care reform is an idea whose time has come.

Sen. Snowe points out that "some very important pieces" have been assembled, and will serve as a basis upon which the Senate and House can work toward a real plan for public health--a plan that will prove as significant in our national history as Medicare has shown itself to be.

Setting up "exchanges" will become the nucleus of our new health care system. "Exchanges" are the new, improved, streamlined public option, because they will ultimately(maybe not immediately) include legislative mechanisms by which competition will thrive (due to price-shopping) and egregious policies (as deniability due to pre-existing conditions) will be weeded out. If our informed citizenry do not drop the ball, here is something our nation can work with to progress toward better public health.

But there's a fly in the ointment: Fiscal responsibility must be maintained, or at least attempted. We can't spend money we don't have. Or at least we must pretend to have it (as does the Fed and the Treas.) That's a bigger factor than you think. In the big picture, that's a health issue as well.

And why do we need to balance a move toward universal health care coverage with provisions for fiscal responsibility?  Sean Brodrick of Uncommon Wisdom  writes: "The Ponzi scheme of the U.S. government buying its own debt can't go on forever. Eventually, the U.S. dollar will crumble, and probably U.S.-dollar-denominated debt along with it."

So the very real possibility of US Government insolvency and bankruptcy must be weighed in our set (public) options. The deficit may seem invisible to most folks now, but in the long run we'll have to pay that 11-trillion-dollar piper his fees-for-service, probably at some future date, and most likely payable not in dollars but in a new world reserve currency such as SDRs or RNBs.

Monetarily and medically, we've got to get this ship of state charted on a viable path.

Why, even Paul Krugman softened a little when he saw the content of the "Baucus" plan, although I do not like to call it that because it is destined, as a work in progress, to become the President's de facto plan. Mr. Krugman writes:

 "Senator Baucus's mark is better than many of us expected. If it serves as a basis for negotiation, and the result of those negotiations is a plan that's stronger, not weaker, reformers are going to have to make some hard choices about the degree of disappointment they're willing to live with." Krugman also mentions: "Several European countries, including Switzerland and the Netherlands, have managed to achieve universal coverage with a mainly private insurance system."

If our nation is to be delivered from bad health, bankruptcy, incivility and certain demise,  moderation  must become the order of the day. And we do have a compass with which to guide us through this stabilizing maneuver.  A big part of our strategy toward that end is found in our Constitution, whic is, according to Sen. Orrin Hatch, "the oldest written charter of government in use in the world today." It has been proven to be a universal template of incredible utility.  Justice Sotomayor agrees: "For as long as I can remember, I have been inspired by the achievement of our Founding Fathers. They set forth principles that have endured for more than two centuries. Those principles are as meaningful and relevant in each generation as the generation before."   

We have a heritage of getting problems worked out. Between the Legislative, the Executive, and the Judicial branches of our democratic/republican government, we can lean on that framework of structured collective responsibility--the  Constitution-- to guide us through these perilous times. We can do it, but we've got to start now. It's not time for anyone to take their ball and go home.

This moderation thing has got to be where it's at.  Why, even Jane Fonda moves toward the center these days, as can be seen in her comment about the explosive apartheid situation in our ally nation, Israel: "it can become counterproductive to inflame rather than explain and this means to hear the narratives of both sides..."

Carey Rowland, author Glass half-Full