"Intelligent discontent is the mainspring of civilization. Progress is born of agitation. It is agitation or stagnation."   Eugene Debs

I've been thinking about the lack of anger at what's transpired in the US and the world regarding the banking crisis.  A crisis in which America's and the world's middle class lost trillions of dollars from their retirement portfolios and pension funds to unregulated gambling by the kingpins of the financial world.  To add insult to injury, one firm that profited by selling the market short as it began its descent received massive amounts of cash from those taxpayers who had lost fortunes in the collapse as did another firm that invented the investment vehicles that led to the downfall.  Perhaps worst of all, the same rubes who lost all that net worth were asked to bail out those firms that precipitated the crisis in the first place. All the while, the legislature wasn't legislating protections, the regulators weren't regulating, the auditors weren't auditing, and the rating agencies were feathering their own nests while fouling ours.  We should all be pissed.  But I'm not seeing much anger, just quiet resolution, shoulder to the wheel, nose to the grindstone, as the lathe of heaven sculpts the future of our parents, ourselves, and our children.

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We've had some spirited debate as to the shape of healthcare reform.  Should it be a single payer system, or a combination of the public option alongside private insurers subject to heavy regulation?  Some have even argued an unfettered free market as the solution to our soaring healthcare costs, although that idea has been considered all but defunct since economist, and Nobel Prize winner, Kenneth Arrow published his seminal work "Uncertainty and the Welfare Economics of Medical Care" some 40 odd years ago, coincidentally giving birth to the field of Health Economics.  His work looked at the effects of 'information asymmetry in the healthcare field.  This is the fact that in most healthcare transactions, one party, (usually the seller), has more information than the other, (usually the consumer).  The upshot of his work is that due to these information asymmetries, the healthcare market should be subject to third party regulation in order to ensure fair and even market distribution of the goods and services not realizable through reliance on a free market norm.  No one who has seriously considered his findings has been able to refute them, yet we have allowed a virtual free market to exist in our healthcare sector despite its' cost eroding our national wealth, impacting our competitiveness in world markets, and failure to offer affordable health insurance to all of the citizens of the wealthiest country on the face of the earth.  So something has to be done, and the question is what, exactly, is that to be?

I'm setting aside, (for the most part), my personal preference for a single payer system in this blog and am going to concentrate on how we get from where we are now to a more streamlined healthcare system that efficiently and economically delivers those needed services to all Americans.  This blog draws heavily from this study done by two highly respected economists for the think tank, Center for American Progress which attempts to set out guidelines for implementing the changes Americans seek in healthcare in a 'revenue neutral' manner.  In other words how do we make these changes pay for themselves, so as to not increase the economic load on the country and its' citizens?  In the author's own words,  "Increasing coverage and saving money requires a complex combination of short- and long-run policies".  Such reforms extend well beyond the so called healthcare reform currently under consideration, which really amounts to 'health insurance reform'.  The way we will get medical costs under control are manifold, and not just limited to the insurance industry.

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