The Best Kind of Choice and the Best Kind of Competition

In our time, word-salads have become common place, confusing to everyone of goodwill.

It is sadly predictable, pace Alice in Wonderland and Through the Looking Glass, to be told that up is down, and down is up.

It was Humpty Dumpty himself, after all, who declared with astonishing arrogance: “When I use a word, it means just what I choose it to mean – neither more nor less.”

In Washington D.C., where I live and work, when a member of the federal bureaucracy uses the words ‘choice’ or ‘competition,’ for example, I find myself, even as a certified non-cynic and non-skeptic, returning to a game of my boyhood called ‘opposite day’ — the point of which is to humorously reverse what has been said or asserted, and only then alighting upon the truth.

In both verbal and non-verbal ways, Americans have almost silently trained ourselves to hear a message, and then apply a version of ‘opposite day’ to what has been communicated so that, in the end, we can approximate what the truth is — a sort of never-ending quest to get to the point beyond the proverbial smoke and mirrors.

A wise, former U.S. senator adroitly and cogently observed, “Everyone is entitled to their own opinions but not to their own facts.”

And so it is refreshing and even nourishing to read a new book Modernizing Medicine (John Hopkins Press, 2023) by scholars Robert Emmet Moffit and Marie Fishpaw, the former a friend and comrade at the Heritage Foundation who has long specialized in health care and its prudent reform, and the latter an adroit policy analyst who has worked at The White House, in the Congress, and is an esteemed health care editor of important work.

Together, Moffit and Fishpaw have written a remarkably useful and helpful guide for American families who are trying to see their way through the endless debates on how our nation’s major entitlements should be reformed, and with a laser-like focus on Medicare and the countless millions of older Americans who rely on Medicare for their health care needs.

With longer life spans, millions of American moms and dads find themselves stretched in a new sort of middle-way.  On the one hand, they are raising young children and pouring their time, talents, and treasure into making and shaping the next-generation of outstanding citizens while on the other hand expending significant amounts of energy and time working to make the lives of their aging parents healthy and fruitful.

It is all expensive – this three-generational-balancing-act – and working to find peace of mind, often through Medicare for older parents, is inevitably a major part of the challenge.

Moffit and Fishpaw have provided an incredibly useful and readable roadmap in navigating these often and predicable policy highways, and they do so in a manner that is clarifying and clear-eyed.

They boldly take on the Herculean task of deducing in easy to understand English (and not the gibberish that often accompanies studies of this kind) the major problems and hurdles of the present system.  As a non-specialist, I was bowled over by the seemingly colossal problems and challenges our beloved country faces in reforming and getting a handle on this governmental-programs-problem which is a kind of Leviathan entitlement matrix voraciously gobbling-up our national treasury and tax dollars.

The authors offer reliable reforms rooted in giving maximum freedom to Medicare’s recipients; they show how transparency into the entire system can be achieved – a major reform that is long overdue and almost criminally negligent; and their section on market reforms rooted in measurable performance as it relates to pricing is the ultimate common-sense in an era when runaway government is what we have all come to expect.

Families can benefit from learning first-hand what major entitlement reform might look like, and how it would directly impact them and those they love.

The authors’ goal in writing this book is equally refreshing: to “secure patients more affordable, more accountable, and higher-quality medical care.”

Former President Reagan famously quipped, “Government is not a solution to our problem, government is the problem.”  He also said, “No government ever voluntarily reduces itself in size.  Government programs, once launched, never disappear.”  Both true indeed; and yet, there is little to know will in Washington to begin the trek toward needed and necessary reform.

The authors are leading the way by providing a GPS through the policy swamps.

Now that Medicare and other related entitlements have vastly expanded in spending, our national debt and deficits are rising concomitantly.  More government means less freedom.

What to do about the dizzying health care challenges before us as America ages and at a time when marriage and fertility rates are at the lowest in American history?

Begin by reading this important book that, almost singularly, is proactively bold and blunt about the challenges we face yet equally sanguine about an achievable way forward that will greatly benefit untold millions of our citizens in the years ahead.

The authors are, dare I say it, courageous, intrepid, fearless, and undaunted about offering a Medicare roadmap that will give the next generation access to high quality care by employing strategies that actually work.

No more Alice in Wonderland, pie in the sky hollow promises that don’t work. Here is a book that elides the health care mechanics that can work. That, after all, is the American way.

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