Commentary

This Economist commentary is in the form of a Blackberry message to Barack Obama, who may be able to help change health care, but may not be able to keep his Blackberry much longer.

This short piece is posted free on the newspaper’s website. Its coverage of American politics, and health care specifically, is insightful and offers a perspective we, who are very close to it, can make good use of.

Although the editors began the campaign year writing as if it was clear that a McCain endorsement was all but a sure thing, in the end, they surprised everyone.

First, the magazine created a “world” electoral college, using the same formulas for assigning electoral votes as the U.S. does for our states, asking readers to vote in a clearly unscientific but fascinating survey. It was Obama by a landslide in informal voting—from almost every county in the world.

Second, the editors endorsed Obama and with enthusiasm. As these folks are unusually blunt about what they see, they surely did not use the poll as an easy way to cross over, but no doubt, it also gave them an understanding of what their own readership was thinking.

It was, editorially speaking, likely a wild ride for such a thoughtful but decisive editorial board.

The letters to the editor, chosen to be balanced, were either delighted or outraged. It never is boring at The Economist. 

Few publications manage to pack as much information of the best quality into tightly written pieces. In one page, they cover a lot of territory. The staff also does a fine job of keeping the news in the news section. Opinion appears in designated columns only.

Check out The Economist online or at your library. Subscription rate is pricey. You need to be a real news junkie to buy this one. However, the newspaper is generous with what it posts online. You can sample it there.

The Economist

“YOU finessed health care brilliantly during the campaign. You ran rings round Hillary on individual mandates, arguing it is unreasonable to require people to buy health insurance when its cost is unknown. You then made mincemeat out of John McCain’s proposal to end the favourable tax treatment of employer-provided health insurance, insisting this would cost most people thousands of dollars. Yet somehow you convinced voters you would expand coverage and tackle costs without resorting to radical plans.

“But now the campaign’s over and it’s time to get real. The good news is that you can still make health a top issue next year, despite the financial mess. The bad news is that to make any headway, you’ll have to be ready to do a few U-turns.

“Part of you is probably wondering if we should shelve health care for now. The short answer: no way, José, for two reasons. One is the economic crisis itself. As unemployment grows, millions will lose their health cover or live in fear of losing it. They will clamour for you to act. You should quickly increase the money given to states to pay for Medicaid and SCHIP (the scheme for children’s health that W. hates so much). You can deflect sceptics by arguing that increased spending on health (which can’t be made in China) will do more to stimulate the economy than issuing tax refunds (which consumers will only squirrel away under their mattresses).

“You might be tempted to go slow, with incremental reforms—say, tackling costs through investments in health information technology. But the coalition for more ambitious reform is growing stronger. Soaring costs have led big business to support universal coverage, while the middle class knows employer-provided health insurance is no longer reliable. The big health insurers have even agreed to cover everyone with pre-existing conditions—but only if we impose an individual mandate.

“The bottom line is this: if we are really going to go for serious reform that tackles both cost and coverage, you are going to have to change your positions on the distortionary tax break for employer-provided coverage and on individual mandates. You can soften the first U-turn by initially only ruling out the most expensive tax deductions; and you can hide the retreat on mandates in a grand presidential compromise. But we can do this. As Rahm Emanuel loves to say, we should never allow a crisis to go to waste.”

Source: The Economist, November 27, 2008, (Print edition). Also posted free on website.